跟骨骨折的手术内固定治疗（附22例报告）

目的探讨使用开放复位可塑型钛钢板内固定治疗累及距下关节跟骨骨折的效果。方法对22例（24足）以后关节突移位为主的跟骨骨折,行跟骨外侧入路、开放复位可塑形钛钢板螺钉内固定,必要时植骨术（3例）。结果术后经平均10.8个月随访,所有患者均恢复正常行走,参照Mary-land food score评分,对患足是否疼痛、步态、距下关节及踝关节活动度、是否支架辅助、术后X线摄片等加以评估,16例足疗效为优、7足为良、1足可。手术切口皮缘坏死1例,换药后自愈。结论对于累及距下关节跟骨骨折行切开复位可塑形钛板固定,必要时植骨术是治疗跟骨骨折的有效方法。

A discussion of the internal fixation for the treatment of calcaneal fracture (22 cases attached)

Objective To probe the use of open-reduction plastic titanium plate internal fixation for the treatment of calcaneal fracture involving subtalar joint. Methods Twenty-two cases （ 24 feet ） of calcaneal fracture mainly with posterior articu- lax process underwent open-reduction titanium plate internal fixation through calcaneal lateral incision, bone grafting adopted if necessary （ 3 cases ）. Results In the postoperative follow-up of mean 10.8 months, all the patients returned to normal walking condition. By referring to Maryland-foot score, a series of assessments were conducted in case of pain, steps, activities of subtalar joints and ankle joints, alternative of subsidiary support and postoperative X-ray. The therapeutic effects showed that 16 feet were excellent, 7 feet good and 1 common. The incisal edge was necrotic in one case which healed after being redressed. Conclusion Open-reduction and internal fixation with titanium plate is a good method in the treatment of calcaneal fracture involving subtalar joint and if necessary bone grafting is recommended.