应用解剖型钛板手术治疗累及距下关节的跟骨粉碎性骨折

目的研究累及关节面的跟骨骨折的手术治疗效果及引起相关合并症的因素分析。方法应用跟骨外侧入路切开复位,并用解剖型钛板固定治疗累及距下关节的跟骨粉碎性骨折23例。结果全部随访,平均23个月,根据Maryland足部评分系统统计疗效。优良率SandersⅡ型为83.3%,Ⅲ型88.9%,Ⅳ型50%。手术合并症主要为切口问题,皮缘坏死率8.7%,感染率4.3%。结论应用解剖型钛板治疗SandersⅡ、Ⅲ型跟骨骨折效果理想。为避免术后切口合并症发生,手术时机应该根据局部软组织情况具体分析决定。

Operative Treatment of Comminuted Calcaneal Fracture Involved Posterior Sub-talar Joint by Titanic Anatomy Plate

Objective To analyze the operative treatment results and complications of the involved articulation calcaneal fracture.Methods From April of 2003 to April of 2007,titanic calcaneal anatomy plate was applied to treat 23 cases of comminuted calcaneal fracture involved posterior sub-talar joint with a lateral approach for the reduction.Results All patients were followed up for an average of 23 months.The data were evaluated with Mayland foot score,the excellent or good rates were 83.3% in Sanders Ⅱ type,88.9% in type Ⅲ,and 50% in type Ⅳ.The primary operative complications derived from the wound were skin necrosis rate at 8.7% and infection rate at 4.3%.Conclusion For the SandersⅡ or Ⅲ calcaneal fracture,treatment with a titanic anatomy plate can receive perfect results.The operative timing should depend on the situation of the soft tissue to avoid post-operative complications.