切开复位钢板内固定治疗根骨关节内骨折32例

目的：对跟骨骨折采用复位钢板内固定治疗的效果进行探讨与分析。方法：选取2011年12月-2012年2月本院人住的跟骨骨折患者32例，共36足。按照Sanders法将所有患足分成标准Ⅱ型11足、标准Ⅲ型17足、标准Ⅳ型8足。对32例患者的跟骨骨折均采用跟骨外侧切开复位钢板内固定治疗，并在手术后6～24个月对患者进行电话随访。结果：所有患者均完成了电话随访，并按照Maryland评分系统对患者的足部功能进行评估。其中，足部功能评价为优2l足，评价为良12足，评价为可3足，优良率可达91．67％。不良反应：2例患足出现手术切口的渗出，但经过换药等操作后自愈；1例患足发生腓肠神经的损伤，不良反应发生率为8．33％。结论：对跟骨骨折采用复位钢板内固定治疗的效果显著，术后足部功能恢复的优良率高，不良反应发生率小，在临床上值得应用和推广。

Thirty-two Cases of Plate Fixation by Open Reduction in Treatment of Internal Calcaneal Fracture

Objective： To study and analyze the therapeutic effects of plate fixation by open reduction in treatment of calcaneal fracture. Method： 32 cases of calcaneal fracture treated in our hospital from December 2011 to February 2012 were selected as the research objects and there were altogether 36 feet. Those feet with calcaneal fracture were divided into three groups according to the Sanders method, which were respectively standard II type （ 11 feet ） ; standard III type （ 17 feet ） ; standard IV type （ 8 feet ） . The calcaneal fracture of these 32 patients were all treated with plate fixation by open reduction outside the calcaneus, and telephone follow-up was carried out to the patients during 6 to 24 months after operation. Result： Telephone follow- up was carried out to all patients, and their foot functions were evaluated according to the Maryland scoring system. Among them, there were 21 feet with excellent functional evaluation, 12 feet with good functional evaluation and 3 feet with passable functional evaluation, and the excellent and good rate reached 91.67%. The adverse reactions included： there were two feet with effusion of operative incision, but they recovered by themselves after fresh dressings for the wounds were changed; there was one foot with damage on the sural nerve, and the total occurrence rate of adverse reactions was 8.33%. Conclusion： The therapeutic effects of plate fixation by open reduction in treatment of calcaneal fracture is obvious, the excellent and good rates in foot function recovery is high, and the rate of adverse reactions is low, so it is worth to be widely applied clinically.