外侧L形切口植骨锁定钛板内固定治疗跟骨骨折  

The treatment of calcaneal fracture with bone grafting and locking titanium plate internal fixation via laternal L-shaped approach

作　　者：杨良军 孙良业 王道德 王波 李品 常谦 YANG Liang-jun;SUN Liang-ye;WANG Dao-de;WANG Bo;LI Pin;CHANG Qian(Dept of Orthopaedics,Lu′an Hospital Affiliated to Anhui Medcial University,Lu′an,Anhui 237005,China)

机构地区：[1]安徽医科大学附属六安医院骨科,安徽六安237005

出　　处：《临床骨科杂志》2022年第1期117-120,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨外侧L形切口植骨锁定钛板内固定治疗PaleyⅢ型跟骨骨折的临床疗效。方法采用外侧L形切口植骨锁定钛板内固定治疗59例PaleyⅢ型跟骨骨折患者(73足)。记录术后并发症和骨折愈合情况,测量Böhler角、Gissane角,根据AOFAS踝-后足评分系统评价疗效。结果患者均获得随访,时间13~16个月。1例术后出现皮缘部分坏死、内固定部分外露,及时行外踝上穿支皮瓣修复;3例术后切口出现渗液,经换药后愈合。术后3 d及3、9、12个月Böhler角、Gissane角均较术前明显改善(P<0.05),术后各时间段间比较差异均无统计学意义(P>0.05)。术后12个月采用AOFAS踝-后足评分系统评价疗效:优55足,良16足,可2足,优良率97.3%。结论采用外侧L形切口植骨锁定钛板内固定治疗PaleyⅢ型跟骨骨折可促进骨折愈合并减少复位丢失,有利于后足功能恢复。Objective To investigate the clinical effect of Paley typeⅢcalcaneal fracture treated with bone grafting and locking titanium plate internal fixation via laternal L-shaped approach.Methods The 59 cases of Paley typeⅢcalcaneal fractures(73 feet)were treated with bone grafting and locking titanium plate internal fixation via laternal L-shaped incision.The postoperative complications and fracture healing,Böhler angle and Gissane angle were recorded and meausred,and the postoperative ankle function was evaluated by AOFAS ankle-hindfoot scoring system.Results All patients were followed up for 13~16 months.One case had partial necrosis of the skin edge and partial exposure of internal fixation after operation,who were repaired with the perforator flap of the lateral malleolus timely;incision leakage occurred in 3 cases after operation,which healed after dressing changes.Compared with the preoperation,the Böhler angles and Gissane angles were improved at postoperative 3 d,3,9,12 months(P<0.05).There were no statistical differences in various periods postoperation(P>0.05).At 12 months after the operation,the AOFAS anklehindfoot scoring system was used to evaluate the efficacy:55 feet were excellent,16 feet were good,2 feet were fair,and the excellent and good rate was 97.3%.Conclusions In the treatment of Paley typeⅢcalcaneal fractures,bone grafting and locking titanium plate internal fixation via lateral L-shaped incision can promote fracture healing and reduce loss of reduction,which are beneficial to the recovery of hindfoot function.

关 键 词：跟骨骨折 PaleyⅢ型 植骨 外侧L形切口 锁定钛板内固定 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]