解剖型钛板内固定及致密植骨治疗跟骨关节内骨折

目的：探讨应用解剖型钛板内固定及致密植骨治疗跟骨关节内骨折的疗效。方法：选取2004年1月-2011年6月本院收治的53例（56足）跟骨关节内骨折患者，采取跟骨外侧入路切开复位，致密植骨支撑关节面骨碎块并用解剖型钛板内固定，围手术期常规应用抗生素防止感染，软组织挫伤严重、血运障碍者高压氧治疗。结果：随访8-32个月，根据Maryland足部评分系统统计疗效。总优良率为83.7%，Ⅳ型优良率为56.2%。结论：采用切开复位解剖型钛板内固定，钛板能有效维持跟骨的整体复位，恢复B？hler’s角、Gissane’s角和跟骨的高度、长度、宽度；骨缺损区致密植骨，关节面骨碎块能得到良好的支撑及复位，高压氧治疗可改善切口软组织局部缺氧状态、血供，促进受损组织再生及愈合，有效预防降低患部皮缘坏死，适时被动和主动功能锻炼，取得较好的临床疗效。

Anatomic Titanium Plate Fixed and Dense Grafting in the Treatment of Intra Articular Calcaneai Fractures

Objective：To investigate the anatomic titanium plate fixed and dense grafting in the treatment of intraarticular calcaneal fractures. Method：Fifty-three patients（56 feet）with intra articular calcaneus fracture in our hospital from January 2004 to June 2006 were selected.They were were treated by calcaneal lateral approach,open reduction,compact bone graft articular surface pieces and fixed by anatomical titanium plate in the peri operation period,the routine use of antibiotics to prevent infection,severe soft tissue injury,blood circulation disorders hyperbaric oxygen therapy. Result：The patients were followed up 8 to 32 months.According to the statistical efficacy of the Maryland Foot Score,excellent and good rate was 83.7%, type IV good rate of 56.2%.Conclusion：The fixed with open reduction and anatomic titanium plate,titanium can effectively maintain the overall reset of the calcaneus,restoration of B？hler’s angle,Gissane’s angle and calcaneal height,length,width;dense bone grafting of bone defects,joint facial bone fragments can get good support and reset,hyperbaric oxygen therapy can improve the incision of soft tissue local hypoxia,blood supply,promoting regeneration and healing of damaged tissue,and effective prevention is to reduce the affected area of skin flap necrosis,timely passive and active functional exercise,achieve better clinical efficacy.