经跗骨窦间隙克氏针加全螺纹松质骨螺钉内固定治疗跟骨骨折

目的：探讨经跗骨窦间隙入路克氏针加全螺纹松质骨螺钉内固定治疗跟骨骨折的临床疗效。方法：自2009年1月至2012年12月采用微创克氏针加全螺纹松质骨螺钉内固定及人工骨植骨治疗跟骨骨折患者20例，男12例，女8例；年龄21～65岁，平均39岁；左足8例，右足12例。骨折按照Sanders分型：Ⅱ型8例，Ⅲ型10例，Ⅳ型2例。结果：20例患者术后获随访，时间6～16个月，平均12个月。切口均甲级愈合。Btihler角由术前的（17．75±4．22）°增大到术后的（26．85±7．37）°（t=4．308，辟0．000）°Gissane角由术前的（137．05±24．91）°减小到术后的（113．75±13．17）°（t=7．083，P=0．000）°术后3个月AOFAS功能评分85．50±7．99，优5例，良11例，可3例，差1例。结论：微创克氏针加全螺纹松质骨螺钉内固定，操作简单，术后固定可靠，易于取出，费用低，并发症少，是治疗跟骨骨折的良好选择，但要把握适当应证。

Treatment of calcaneal fractures by fixation of Kirschner needle and thread cancellous bone screw through sinus tarsi interstice

To explore the effect of fixation of Kirschner needle and thread cancellous bone screw through the sinus tarsi interstice for the treatment of calcaneal fractures. Methods： From January 2009 to December 2012,20 patients with calcaneal fracture were treated by minimally invasive Kirschner wire and threaded cancellous bone screw fixation and bone graft, including 12 males and 8 females with an average age of 39 years old ranging from 21 to 65. Among them, 8 cases were left foot, 1.2 were right foot. According to Sanders＇s classification, 8 cases were type Ⅱ, 10 cases were type Ill, 2 cases were type IV. Results：All patients were followed up from 6 to 16 months with an average of 12 months. The incision were healed. Btihler angle were increased from preoperative （17.75±4.22）°to postoperative （26.85±7.37）°（t=4.308,P=0.000）. Gissane angle were reduced from preoperative （137.05±24.91）°to postoperative （113.75±13.17）° （t=7.083,P=0.000）. At 3 months after operation, the scores of AOFAS were 85.50±7.99 ;the results were excellent in 5 feet and good in 11 feet, fair in 3 feet, and poor in 1 foot. Conclusion： Minimally invasive fixation of Kirschner needle and thread cancellous bone screw fixation is a simple operation,it can get reliable fixation, easy to remove ,low cost,less postoperative complications, and it is a good treatment of calcaneal fracture.