经皮撬拨复位空心钉内固定治疗跟骨关节内骨折

目的：总结经皮撬拨复位空心钉内固定治疗跟骨关节内骨折的手术经验。方法：2007年6月-2010年6月，采用经皮撬拨复位空心钉内固定治疗跟骨骨折24例，其中SandersⅡ型19例（Ⅱa型3例，Ⅱb型5例，Ⅱc11例），SandersⅢac型5例。结果：所有患者术后随访12-24个月（平均16个月）。术后均未发生切口感染、螺钉断裂及跟骨内翻等并发症。术后平均骨折愈合时间为14．5周。按美国足踝外科协会（AOFAS）后足评分系统评价疗效，优17例，良5例，一般2例，优良率91．6％。X线片检查示Bohler角、Gissane角、跟骨外形基本恢复正常。结论：经皮撬拨复位空心钉内固定适用于治疗SandersⅡ，Ⅲ；型跟骨骨折，具有操作简单、并发症少和临床疗效好等优点。

Percutaneous Reduction and Internal Fixation in the Treatment of Intra-articular Calcaneal Fractures

Objective： To sum up the experience of percutaneous and internal fixation of intra - articu- lar calcaneal fracture. Methods：Fom June 2007 to June 2010, Percutaneous reduction and internal fixtion was performed on 24 cases with intra - articular calcaneal fractures. According to Sanders classification, there were 19 feet of type Ⅱ（3 type Ⅱ a,5 type Ⅱ b and 11 type Ⅱ c） and 5 feet of type IIIac. Results：All patients were fol- lowed up for an average of 16 months （ranged froml2 to 24 months）. No complications such as wound infec- tion, screw breakage and calcaneum varus were found postoperatively. The average time for bone healing was 14.5weeks. The results were excellent in 17 cases, good in 5 cases, average in 2 cases according to the Ameri- can Orthopaedic Foot and Ankle Society （AOFAS） hindfoot score. The rate of excellent and good clinical re- sults was 91.6%. Radiography showed basic restoration of Bohler＇ s angle,Gissane＇ s angle and calcaneal shape. Conclusions：Percutaneous reduction and internal fixation is suitable for surgical treatment of SandersⅡ and Ⅲ type calcaneal fractures, with advantages of simple operation, fewer complications and good clinical re- sults.