跟骨钛钢板治疗跟骨关节内骨折临床分析

目的 探讨应用跟骨钛钢板治疗跟骨关节内骨折的疗效。方法对2002年10月～2008年12月收治跟骨关节内骨折48例进行回顾性分析。所有患者均为闭合性骨折。按Sanders分型，Ⅱ类A型19例、Ⅱ类B型15例，Ⅱ类C型10例，ⅢAC型4例。对48例累及距下关节的跟骨骨折采用切开复位跟骨钛钢板内固定伴自体髂骨或人工骨植骨治疗。结果获得完整随访资料42例．经5个月-5年随访．患者均获得骨性愈合，平均骨愈合时间12个月。采用Maryland足部评份标准评价手术效果，优26例，良15例，优良率达86％。术后主要并发症为慢性疼痛1例、切口皮肤坏死2例、感染2例。结论跟骨钛钢板结合自体髂骨或人工骨植骨治疗跟骨关节内骨折固定可靠．可早期功能锻炼，是目前一种治疗有移位跟骨关节内骨折的较好方法。

The clinical analysis in the treatment of intraarticular calcaneus fracture with internal fixation of titanium plate

Objective To explore the effects of internal fixation with titanium plate for the treatment of intraarticular fracture of caleaneus. Methods From October, 2002 to December, 2008, the climical data of ＂48 cases with calcaneus fracture involving the articulatio subtalaris were analyzed retrospectively. According to the Sanders eriteia, the typers of Ⅱ A, Ⅱ B, Ⅱ C and ⅢAC were in 19,15,10 and 4 cases respectively. All cases were operated with the open reduction and internal fixation with titanium plate. During the operation,the self-ilium or the artificial bone graft were applied. Results 42 cases were followed＂ up for 5 to 36 months. All cases obtained bone union in average 12 months. According to the Maryland criteia, the excellent and good rates were 86%. Conclusions Internal fixation with titanium plate and transplantion with the self-ilium or the artificial bone graft are ＇an excellent method for the treatment of intraarticular fracture of calcaneus.