多根克氏针内固定治疗跟骨骨折

目的探讨跟骨骨折的多根克氏针固定及其疗效。方法对26例（31侧）Sander分型Ⅱ6侧、Ⅲ型18侧、Ⅳ型7侧的跟骨骨折患者，采用多根克氏针内固定，其中12侧取自体髂骨植骨，观察治疗前后Bohler角、Crssane角和跟骨后关节面位移恢复情况，按Maryland足部评分系统评价术后恢复程度。结果随访时间7—38个月，平均11个月。治疗前后Bohler角、Gssane角和跟骨后关节面位移恢复情况均P〈0．01；按Maryland足部评分系统评价，优15侧、良11侧、可4侧、差1侧，优良率为84．2％。结论多根克氏针内固定，必要时充填自体髂骨，切口小，对皮瓣影响小，跟骨外形基本恢复正常，足部功能恢复好，近中期疗效满意。

Multi-kirschner internal fixation in the treatment of calcaneal fracture

Objective To investigate the operative options and the effects of calcaneal fractures. Methods 26 cases(31 sides) calcaneal fractures in patients of Sander Ⅱ(6),Ⅲ(18),Ⅳ(7)were treated by internal fixation with Multi-Kirschner. Results All cases were followed up from 7 to 38 months and evaluated according to Maryland Foot Score System. The handfoot function was excellent in 15 sides, good in 7, fair in 4 and poor in 1, and excellent and good rate reached 84.2%.The postoperative X-ray film showed that the Bohler aggle, Gssane aggle and the post-plane of calcaneal was significant(P＜0.01).Conclusions The operative incision of multi-Kirschner internal fixation was relatively smaller and litter influence to flap.To analyze the fracture according to CT scan,and sustain in the fractures with posterior-articular,distal bone of calcaneal,cuboid and scaphoid,and fill in iliac bone graft as necessary.The treatment had obtained firm fixation and satisfactory effects.