跟骨结节内侧突骨折的手术治疗  

Surgery for fractures of the medial process of calcaneal tuberosity

作　　者：李兵[1] 杨云峰[1] 陈大伟[1] 朱辉[1] 陈凯[1] 张明珠[1] 于涛[1] 赵有光[1] 俞光荣[1] 

机构地区：[1]同济大学附属同济医院骨科上海市同济医院骨科,200065

出　　处：《中华创伤骨科杂志》2014年第9期741-743,共3页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（81071471）

摘　　要：目的 探讨切开复位内固定治疗跟骨结节内侧突骨折的疗效. 方法 2010年1月至2012年1月采用手术治疗跟骨结节内侧突骨折患者12例（13侧）,男10例,女2例;年龄20 ～ 39岁,平均30.5岁.均采用切开复位单纯半螺纹螺钉固定（8侧）或微型钢板固定（5侧）. 结果 10例患者（11侧足）术后获12 ～ 24个月（平均14个月）随访.所有患者均一期愈合.骨折愈合时间为8～13周（平均11周）.无骨折不愈合及内固定物松动、断裂等并发症出现.患者术后9～14周（平均12周）可完全负重行走,无明显疼痛不适.末次随访时美国足踝外科协会的踝-后足评分为84 ～100分,平均90.4分. 结论 跟骨结节内侧突骨折的解剖复位和确切固定是维持足跟正常形态、恢复足跟负重重心和足弓功能的关键.需根据骨折移位的具体情况,选择合适的治疗方法,以提高临床疗效.Objective To investigate the therapeutic outcomes of open reduction and internal fixation for fractures of the medial process of calcaneal tuberosity.Methods From January 2010 to January 2012,12 patients with fracture of the medial process of calcaneal tuberosity at 13 sides were treated by our department.They were 10 males and 2 females,with an average age of 30.5 years （range,20 to 39 years）.One of the male patients suffered from bilateral fractures of the medial process of calcaneal tuberosity.The surgical treatments included open reduction,internal fixation by mini-plate or screws.In our cases,isolate screw fixation was used in 8 fractures,and mini-plate fixation was used in 5 fractures.Results Ten patients with 11 fractures were followed up for 14 months on average （range,12 to 24 months）.All the cases healed uneventfully.No infection or fixation failure was found.The mean time of bone union was 11 weeks （range,8 to 13 weeks）.Full weight bearing was achieved in a mean time of 12 weeks （range,9 to 14 weeks） with no obvious pain or discomfort.According to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale,the mean score was 90.4 （range,84 to 100） at the final follow-up.Conclusions In the treatment of fractures of the medial process of calcaneal tuberosity,anatomic reduction and stable internal fixation is the key to recovery of the calcaneal morphology and normal gait.A suitable therapeutic strategy based on the fracture pattern can benefit the clinical outcomes.

关 键 词：跟骨 骨折 骨折固定术 内 内固定器 

分 类 号：R687.3[医药卫生—骨科学]