有限内固定治疗开放性跟骨骨折

目的：探讨应用有限内固定（克氏针、空心钉）治疗GustiloⅠ～Ⅲ型开放性跟骨骨折的方法及其疗效。方法对17例（男性15例，女性2例；年龄23～64岁，平均43.5岁） GustiloⅠ～Ⅲ型开放性跟骨骨折患者应用有限内固定治疗，观察伤口愈合及治疗前后B?hler角、Gissane角恢复情况。结果17例创面均愈合，有4例发生创面软组织缺损，经过皮瓣修复覆盖伤口愈合。全部患者随访6～12个月，平均10个月，复位无丢失，骨折均愈合。按Maryland足功能评价优11例，良4例，可1例，差1例，优良率达88.2％。术后患者的B?hler角、Gissane角较治疗前显著改善，P＜0.05。结论有限内固定治疗Gustilo Ⅰ～Ⅲ型开放性跟骨骨折方法简便，既能有效地复位固定，而且对开放性创面的处理有明显优势，大大降低皮肤感染或坏死的概率，减少创伤，是治疗开放性跟骨骨折的有效方法。

Limited internal fixation in the treatment of open calcaneal fracture

Objective To evaluate the application of limited internal fixation( Kirschner,hollow nail) and its effect in the treatment of Gustilo typeⅠ-Ⅲopen fracture.Methods Seventeen cases(15 males and 2 females aged from 23-64 years with an average age of 43.5 years) of Gustilo typeⅠ-Ⅲopen fractures were treated with limit-ed internal fixation.The healing status,B?hler’ s angle before and after the treatment,the angle of Gissane were ob-served.Results All patients were healed, among them 4 cases suffered soft tissue defects and healed after skin flap.All patients were followed up for 6-12 months,average 10 months.All fractures healed without loss of reduc-tion.According to Maryland foot score,11 cases were excellent,4 cases were good and 1 case was poor;the excel-lent and good rate was 88.2%.B?hler’ s angle of patients and the angle of Gissane improved significantly after treatment (P<0.05).Conclusion Limited internal fixation has advantages in the treatment of open wound and greatly reduces the probability of infection or necrosis of the skin.It is a simple and effective method in the treat-ment of Gustilo type I-Ⅲopen fracture.