钢板内固定治疗跟骨骨折24例疗效观察

目的探讨手术钢板内固定治疗跟骨骨折的疗效。方法 2003-05～2009-05共行手术钢板内固定治疗跟骨骨折24例(26足)。男18例,女6例。年龄20～42岁,平均24.6岁。致伤原因:坠落伤17例,车祸伤5例,挤压伤2例;根据Sanders分型,其中Ⅲ型19例,Ⅳ型5例。术后采用Maryland Foot Score系统进行功能评价。结果 24例术后均获随访8～36个月,平均10.4个月,骨折全部愈合,其中优12例,良9例,可2例,差1例,优良率为87.5%。术后切口延迟愈合3例,无感染、无皮肤坏死及医源性神经损伤。结论掌握手术指征、正确骨折复位、恢复距下关节面是治疗的关键,手术钢板内固定治疗跟骨骨折是一种较理想的方法。

Operative treatment of calcaneal fractures with the calcaneal plate: report of 24 cases

Objective To investigate the effect of operative treatment of calcaneal fractures with calcaneal plate.Methods Form May 2003 to May 2009,operative treatment of 24 cases of calcaneal fractures of all kinds(26 feet) were performed.Of them 18 cases were male and 6 cases were female.The average age was 24.6 years(20～42 years).Injury cause:17 cases suffered drop,5 cases surfered traffic accident,2 cases surffered extrusion.According to Sanders classification system,19 cases of typeⅢand 5 cases of typeⅣ.Results All patients were fellowedup for 8～36 months(average 10.4 months).According to Maryland Foot Score criteria,all cases recovered with good healing of fractures.The excellent outcome were found in 12 cases,good in 9 cases,fair in 2 cases,poor in 1 case.The excellent and good rate was 87.5%,delay healing were found in 3 cases;no infection and necrotic skin of incision were found in all cases.Conclusion It is important for treatment to regain the flatness of subtalar joint,select the surgery indication and reduction approach correctly.Plate internal fixation is an ideal measure to treat calcaneal fractures.