跟骨关节内骨折重建板固定效果评定

目的评价应用跟骨重建钢板治疗跟骨关节内骨折的临床疗效。方法回顾性分析2005年3月至2008年3月治疗的38例跟骨关节内骨折患者的临床资料,按照Sanders分型分为,Ⅱ型12例,Ⅲ型15例,Ⅳ型11例。术中根据情况部分病例采用内外侧联合切口,骨缺损严重者行自体或同种异体骨移植,所有骨折均使用重建板内固定治疗。结果 38例经治疗后,所有切口Ⅰ期愈合,无钢板外露,距下关节面的解剖学关系和跟骨的高度、长度、宽度得到较好恢复,患者随访时间平均26个月（12～48个月）,骨折愈合良好。据Maryland足部评分系统（MarylandFootScore,MFS）,从患者对疼痛主观感觉、功能恢复、运动情况和手术局部外观等方面进行评分,38例中,优28例,良7例,一般3例,优良率92%,整体治疗效果及功能评价满意。结论应用跟骨重建板治疗SandersⅡ、Ⅲ、Ⅳ型跟骨关节内骨折,在恢复跟骨形态的同时能取得较好的临床疗效。

Evaluation of the outcome of intra-articular calcaneal fracture with reconstructive alloy plate

Objective To evaluate clinical outcome of the calcaneal reconstruction alloy plate in the treatment of intra-articular calcaneal fractures. Methods A retrospective analysis was performed on 38 cases of intra-articular calcaneal fractures from March 2005 to March 2008 treated with reconstructive alloy plate. According to Sanders classification,the patients were divided into Ⅱ type （12 cases）,Ⅲ type （15 cases） and Ⅳ type （11 cases）. All patients with the lateral incision,severe bone defects with autologous or allogeneic bone graft,and all fractures were treated with internal fixation by titanium alloy plate. Results Patients were followed up for an average of 26 months （12 to 48 months） after treatment. The incisions in all cases were healed without plate exposure,anatomy relationship between subtalar joint and the height,length and width of calcaneus got a better recovery. According to Maryland Foot Score （Maryland Foot Score,MFS）,we graded the patient＇s by sensation of pain,function,movement and local appearance. There were excellent in 28 cases,good in 7 cases,fine in 3 cases with the good rate being 92%. Overall therapeutic effects and functional evaluation were satisfactorily with the treatment of 38 cases. Conclusion Application of titanium alloy plate in the treatment of calcaneal Sanders Ⅱ,Ⅲ,Ⅳ-type intra-articular calcaneal fractures could restore calcaneal morphology and achieve better clinical efficacy.