30例跟骨关节内骨折的手术治疗  

The Evaluate of the Surgical Treatment for 30 Cases Intraarticular Calcaneal Fractures

作　　者：李伟[1] 刘金标[1] 谢美明[1] 潘显明[1] 权毅[1] 杨丽娜 

机构地区：[1]成都军区总医院骨科,四川成都610083 [2]四川省医疗卫生技术咨询所,四川成都610041

出　　处：《四川医学》2014年第8期932-934,共3页Sichuan Medical Journal

基　　金：四川省卫生厅科研课题(编号130325)

摘　　要：目的评价切开复位重建钢板内固定术治疗跟骨关节内骨折的早期临床疗效。方法本组30例,34足跟骨骨折。男21例,女9例;年龄18~57岁（平均37.6岁）。双侧骨折4例。所有患者术前行跟骨正、侧位及轴位X线摄,并行跟骨CT扫描三维重建。骨折按Paley分型,Ⅰ型（剪力骨折）3足,Ⅱ型（舌型骨折）16足,Ⅲ型（中央塌陷型骨折）7足,Ⅳ型（粉碎型骨折）4足,Ⅴ型（严重粉碎型骨折）4足。所有患者均采用切开复位、重建钢板内固定术。术后拍X线片,按Maryland足部评分系统评价术后功能。术后平均随访9个月（6~36个月）。结果术后早期X线片显示34足跟骨骨折都获得了良好复位,根据Maryland足部功能评分,优17足,良13足,可3足,差1足。结论采用切开复位内固定治疗跟骨关节内骨折,可以取得良好的手术效果。Objective To evaluated the early clinical effects of open reduction and internal fixation for the treatment of intrartieular（ subtalar joint） calcaneal fractures. Methods 34 feet of 30 patients with intraarticular fractures of the calcaneus we received. Twenty-one patients were males and nine were females（ mean age 37. 6 years; range from 18 to 57 years） , and four patients suffered from bilateral fractures. Anteroposterior, lateral, and tangential radiographs were obtained in all patients preoperatively, and all patients experienced computed to mography（CT） scans. According to Pale y＇s classification, there were 3 cases in type Ⅰ ,16 in type Ⅱ ,7 in typeⅢ ,4 in typelVand 4 in typeV. An extensile lateral incision was performed in all patients to provide an anatomic reduction with the use of rebuilt-plates, screws internal fixation. The 30 patients were followed up with an average time of 9 months（ range from 6 to 36 months）. Results Radiographs obtained in the early postoperative period showed that complete anatomic reduction were achieved in 19 feet. According to the Maryland Foot Score, the results were excellent in 17, good in 13 ,fair in 3 ,and poor in 1 foot. None of patients required a subsequent operation due to surgery associated causes. Conclusion The treatment effects of intraarticular calcaneal fractures with ORIF are satsifactory.

关 键 词：跟骨骨折 切开复位内固定 钢板固定 

分 类 号：R687.3[医药卫生—骨科学]