外侧切口治疗跟骨骨折

目的探讨外侧切口手术治疗跟骨骨折的效果。方法2009年9月～2011年12月采用外侧切口治疗跟骨骨折21例，男15例，女6例；年龄31～65岁，平均48．3岁。单侧足19例，双侧足2例。坠落伤17例，压砸伤g例。按Sanders分型：Ⅱ型9足、Ⅲ型11足、Ⅳ型3足。手术时间为伤后5～12d。结果随访10～24个月，平均16个月。术后3足出现皮缘浅表坏死，经换药后瘢痕愈合；2足出现足外侧缘皮肤麻木。17足术后摄x线片见关节面复位良好，跟骨外形高度与宽度恢复满意；6足术后Bohler角和Gissane角较术前明显好转，但未完全恢复正常；疗效根据Maryland评分标准：优13足，良6足，可4足，优良率为82．6％。结论外侧切口治疗跟骨骨折，骨折线显露清晰，可恢复距下关节面及跟骨关节面平整，维持正常足弓形态和跟骨宽度，并有足够的空间放置钢板螺钉，妥善保护后可使软组织损伤减少，适用于SandersⅡ型骨折和关节面较粉碎的SandersⅢ型骨折。

Treatment of calcaneal fracture with the lateral incision.

Objective To explore the effects of lateral incision surgical in treatment of calcaneal fractures. Methods From September of 2009 to December of 2011 using the lateral incision surgical treatment of calcaneal fractures in 21 patients： 15 males and 6 females; ages 31-65 years old, with an average of 48. 3 years old. Unilateral calcaneus in 19 cases, bilateral in 2 cases, fall injury in 17 feet, crush injury in 4 feet. According to Sanders type： type Ⅱ 9 feet, type Ⅲ 11 feet, type Ⅳ 3 feet. The surgery time was 5-12 days after injury. Results Follow-up of 10-24 months, with an average of 16 months. 3 feet with superficial necrosis of skin flap, scar healing after changing dressing; 2 feet with lateral edge of the skin is numb. 17 feet postoperative X-ray films showed that the articular surface reset good, calcaneal height and width satisfactory recovery; 6 feet postoperative Bohler angle and Gissane angle than before surgery significantly improved, but not completely back to normal. Conclusion The efficacy by Maryland scoring criteria： excellent in 13 feet, good in 6 feet, general in 4 feet, good rate of 82.6%. Lateral incision treat calcaneal fractures have such advantages： fracture lines revealed clear, subtalar articular surface and formation calcaneocuboid articular surface can recoverable to normal arch form and calcaneal width, and have enough space to place plates and screws, which will properly protected Soft tissue. Sanders Ⅱ fractures and articular surface crushed Sanders Ⅲ fractures is applicable.