跟骨解剖板治疗累及跟距关节的粉碎性跟骨骨折的临床研究

目的 研究应用特制跟骨解剖板治疗严重粉碎性跟骨骨折的临床应用价值。方法 自1999年1月～2001年8月，应用跟骨解剖板治疗严重粉碎的跟骨骨折14例，术前、术后采用静脉泵消除肿胀，配合抗真菌治疗。术中注意关节面、Bohlei角及临界角的复位，同时采用跟骨解剖板及松质骨螺钉进行牢固固定。结果 14例病人平均随诊23个月，病人主观症状满意率85．7％，足部外形优92．9％，足及踝关节活动优71．4％，Btihler角优78．6％。总体优良率98．3％。结论 跟骨解剖板治疗严重粉碎的跟骨骨折，固定牢固，允许术后早期功能练习，能最大限度的减少骨折后的并发症。

Clinical study on management of comminuted calcaneal fracture involved calcaneal-talus joint with calcaneal anatomy plate

Objective To evaluate the clinical value of applying special calcaneal anatomy plate to treat serious comminuted fracture of calcaneus, with consideration of its frequent complications and difficulties in treatment. Methods From January 1999 to august 2001, we applied calcaneal anatomy plates to treat 14 cases of serious crumbled fracture of calcaneus. The vein pump was used to decrease the swelling before and after operation. Anti mycete measures were taken. During operation, we paid attention to the reduction of articular face, Bohler angle and critical angle, and made secure internal fixation with calcaneal anatomy plate and cancellous bone screw. Results 14 cases were followed up for 23 months averagely. 85.7% of the patients were satisfactory with the remission of subjective symptoms, while the rate of excellent foot outline was 92.9% . The rate of excellent joint motion of foot and ankle was 71.4% , and the rate of excellent Bohler angle was 78.6% . The overall excellent and good rate was 98.3% . Conclusion Applying the calcaneal anatomy plate to treat serious crumbled fracture of calcaneus and paying attention to good reduction, can acquire secure internal fixation, and permit patients to exercise earlier after operation, and can greatly decrease complications of calcaneal fracture.