跟骨解剖钛板治疗累及跟距关节面的跟骨骨折

【目的】评价跟骨解剖型钛板治疗累及跟距关节面的跟骨粉碎性骨折的疗效。【方法】自2000年3月至2007年10月，应用解剖型钛板治疗累及跟距关节面的跟骨粉碎性骨折39例，术中注意关节面及Bohler＇s角的复位，同时应用解剖型钛板及松质骨螺钉进行内固定，术中均给予髂骨植骨。【结果】平均手术时间70（60-100）min、平均手术出血量450（400-600）mL。早期进行功能锻炼，随访时间6．4（4-21）个月。术后平均植骨融合时间3．3个月，功能恢复优16侧（16／39，41．02％），良14侧（14／39，35．90％），可6侧（6／39，15．38％），差3例（3／39，7．69％），优良率76．92％（30／39）。【结论】解剖型钛板能够有效地支撑塌陷的跟骨关节面，是一种合理的跟骨骨折内固定器，固定牢固，病人接受治疗后可早期进行功能锻炼。

Treatment of Comminuted Calcaneal Fracture Involved Calcaneal-talus Joint with AO Anatomic Plate Internal Fixation

[Objective] To evaluate retrospectively the outcomes of the treatment of comminuted calcaneal fracture involved calcaneal-talus joint with anatomic plate internal fixation. [Methods] Thirty nine patients suffered from comminuted calcaneal fracture involved calcaneal-talus joint were treated with the anatomic plate internal fixation combined with cancellous bone screw and ilium grafting between March 2000 and October 2007. The reduction of the articular surface of the calcaneal-talus joint and the Bohler angle were paid attention during operation. The outcomes of both the treatment and the function of joints involved were graded into the excellent, the good, the fair and the poor according to Maryland Foot Score. [Results]The average operative time was 70min（ranged from 60 to 100）, and the hverage amount of bleeding during operation were 450ml （ranged from 400 to 600）. The patients had exercised early after operation. After an average duration of 6.4 months of follow-up ranging from 4 to 21 monthS., the average grafting bone fusion time were 3. 3 months postoperatively. The outcomes of both the treatment and the function of joints involved were excellent in 16 cases （16/39, 41.02%）, good in 14 cases （14/39, 35.90%） , fair in 6 cases （6/39, 15.38%） and poor in 3 cases （3/39, 7.69%） out of the 38 cases according to Maryland Foot Score, and the rate of excellent and good was 76.92% （30/39）. [Conclusion] Being able to effectively support the articular surface of calcaneus, the anatomic plate is a fine internal fixation device for calcaneal fractures, moreover it can supply with excellent internal fixation and permit the patients to exercise early after operation.