锁定跟骨钢板治疗新鲜跟骨骨折

目的 探讨采用锁定跟骨钢板治疗新鲜跟骨关节内移位骨折的临床疗效.方法 2004年10月至2006年10月,治疗34例男性闭合性跟骨关节内移位骨折患者,年龄19～42岁,平均34岁;左足14例,右足20例;高处坠落伤22例,车祸伤12例.受伤至手术时间7～21天,平均13天.术前均对伤足摄正、侧位X线片及跟骨的CT轴位片.根据Sanders分型,Ⅱ型16例,Ⅲ型18例.采用扩大外侧入路对34例患者进行手术,骨折复位后利用锁定跟骨钢板完成骨折内固定.结果 28例患者获得随访,随访时间6～40个月,平均20个月.切口均甲级愈合.B(o)hler角由术前平均7.41°±4.08°改善至术后第7天的29.74°±5.56°和术后3个月的30.00°±5.53°;Gissane角由术前平均163.71°±9.31°改善至术后第7天的122.59°±14.11°和术后3个月的125.85°±19.31°.骨折均愈合,愈合时间为6～12周.术后无一例患者发生撞击或神经、血管损伤等并发症,未出现骨折移位或内固定失败等情况.术前美国足踝外科学会(American Orthopaedic Foot & Ankle Society,AOFAS)评分系统的踝-后足评分为(17.68±9.34)分,术后3个月和6个月分别为(74.79±4.01)分和(74.28±17.92)分.结论 应用锁定跟骨钢板治疗新鲜跟骨骨折,可以获得满意的临床效果,利于患者的功能恢复.

Abstract：

Objective To evaluate the clinical outcome of operative management of displaced intraarticular fractures of the calcaneus using locking plates. Methods From October 2004 to October 2006, 34patients with close displaced intraarticular fractures of the calcaneus were fixed with Calcaneal locking Plates through the extensive lateral approach. The right foot was involved in 20 patients. The mean age was 34 yesrs with a range of 19 to 42 years. Accordiing to Sanders' classification system, there were 16 patients in style Ⅱ and 18 in style Ⅲ The mean interval between injury and operation was 13 days Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a locking calcaneal fracture plate. The result were evaluated with AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot scale. Results Twenty-eight patients were followed up. The follow-up duration ranged from six to forty months, with the mean of twenty months. angle and were measured at, The average B(o)hler angle was 29° and 30° and the average Gissane was 122° and 125° seven days and three months after operation. Bone union was achieved in all cases. All incisons had healed smoothly. No patient sustained lateral impingement syndrome or soft tissue complications The mean AOFAS scores that was measured three months and six months after operation was 74. Conclusion The application of the calcaneal locking plates through extended lateral approach is proved to be an effective treatment for displaced intra-articular calcaneal fracture, offering the combination of good reduction and early rehabilitation.

Operative treatments of displaced intraarticular fractures of the calcaneus with locking plates

Objective To evaluate the clinical outcome of operative management of displaced intraarticular fractures of the calcaneus using locking plates. Methods From October 2004 to October 2006, 34patients with close displaced intraarticular fractures of the calcaneus were fixed with Calcaneal locking Plates through the extensive lateral approach. The right foot was involved in 20 patients. The mean age was 34 yesrs with a range of 19 to 42 years. Accordiing to Sanders' classification system, there were 16 patients in style Ⅱ and 18 in style Ⅲ The mean interval between injury and operation was 13 days Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a locking calcaneal fracture plate. The result were evaluated with AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot scale. Results Twenty-eight patients were followed up. The follow-up duration ranged from six to forty months, with the mean of twenty months. angle and were measured at, The average B(o)hler angle was 29° and 30° and the average Gissane was 122° and 125° seven days and three months after operation. Bone union was achieved in all cases. All incisons had healed smoothly. No patient sustained lateral impingement syndrome or soft tissue complications The mean AOFAS scores that was measured three months and six months after operation was 74. Conclusion The application of the calcaneal locking plates through extended lateral approach is proved to be an effective treatment for displaced intra-articular calcaneal fracture, offering the combination of good reduction and early rehabilitation.