手术治疗67例跟骨骨折疗效观察及分析

目的探讨切开复位跟骨解剖钢板内固定术、自体骨植骨术对跟骨骨折的治疗疗效．方法自2002年6月至2009年4月我科对67例SandersⅡ、Ⅲ、Ⅳ型骨折开展切开复位跟骨解剖钢板内固定加自体骨植骨术治疗跟骨骨折，术后建立随访机制，观察疗效．结果本组病例中67例患者术前Bolher角15°±3°，术后为40°±4°（P〈0．05），术前Gissane角90°±6°，术后130°±10°（P〈0．05）．发生并发症1例，为术后伤口皮肤坏死（坏死率为1．5％），经过换药后植皮治愈，并未留下后遗症．其余病人均甲级愈合．结论切开复位跟骨解剖钢板内固定术，自体骨植骨术治疗跟骨骨折能够取得显著疗效．术前充分有效的准备和手术医生对跟骨骨折的特点和基础解剖熟悉掌握以及手术注意和技巧是手术治疗成功的关键．

Effect of Operation on 67 Cases of Calcaneal Fracture

Objective To investigate the surgery effect of calcaneal fracture by observing and analyzing 61 cases of open reduction, autogenous bone graft and anatomic plate fixation of calcaneal fracture. Method From June 2002 to April 2009, 67cases of sanders Ⅱ , Ⅲ , Ⅳ calcaneal fracture were performed open reduction, autogenous bone graft and anatomic plate fixation, the result was observed and analyzed. Result For the 67cases of patients, preperative Bolher angles were 15 ° ± 3° , postoperative bolner＇s angles were 40° ±4° （P 〈 0.05）. Preperative Gissane angles were 90°± 6° and postoperative angles were 130° ± 10° （P 〈 0.05 ）. Only one suffered recrosis of skin around the incision （ 1.5% ） , others got satisfied skin cure （98.5%）. Conclusions Open reduction, autogenous bone graft and anatomic plate fixation is effective for the treament of calcaneal fracture. Through effective preparation before operation and the surgery＇s familiarity of calcaneal fracture and basic anatomic of calcaneal are the key factors of the operation.