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严重移位的跟骨关节内骨折的手术治疗
Hits: 1843   Download times: 1196   Received:July 11, 2006    
作者Author单位UnitE-Mail
刘立峰 LIU Li-feng 济南军区总医院骨创科,山东济南250031 Traumatic Orthopaedic Department,the General Hospital of Jinan Military Command,Jinan 250031,Shandong,China llf919@sina.com 
蔡锦方 CAI Jin-fang 济南军区总医院骨创科,山东济南250031 Traumatic Orthopaedic Department,the General Hospital of Jinan Military Command,Jinan 250031,Shandong,China  
梁进 LIANG Jin 济南军区总医院骨创科,山东济南250031 Traumatic Orthopaedic Department,the General Hospital of Jinan Military Command,Jinan 250031,Shandong,China  
张强 ZHANG Qiang 济南军区总医院骨创科,山东济南250031 Traumatic Orthopaedic Department,the General Hospital of Jinan Military Command,Jinan 250031,Shandong,China  
王平山 WANG Ping-shan 济南军区总医院骨创科,山东济南250031 Traumatic Orthopaedic Department,the General Hospital of Jinan Military Command,Jinan 250031,Shandong,China  
期刊信息:《中国骨伤》2007年20卷,第5期,第328-329页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:研究移位的跟骨关节内骨折的手术治疗方法。

方法:移位的跟骨关节内骨折32例35侧,男22例,女10例;平均年龄39.4岁;左侧16例,右侧13例,双侧3例。按Sanders分型法分型,SandersⅢ型21侧,Ⅳ型14侧。对所有病例采用延长的外侧途径应用钢板松质骨螺钉联合固定治疗,钢板为跟骨解剖钢板。

结果:32例均获随访,随访时间4~62个月,平均25个月。依据Maryland足部评分评价,优14侧,良8侧,中10侧,差3侧。治疗后并发症主要为伤口裂开并表浅皮肤感染2例,皮肤感染并全层坏死1例,距下关节炎4例,腓骨肌腱炎2例,跟部增宽3例,跟骰关节炎2例。Bhler角与Gissane角术前与术后对比均有显著统计学差异。

结论:以延长的外侧途径为入路应用钢板螺钉联合固定治疗移位的跟骨关节内骨折,术后可早期功能锻炼,减少骨折的并发症。
[关键词]:跟骨  骨折  骨折固定术,内  外科手术
 
Operative treatment of displaced intra-articular fractures of the calcaneus
Abstract:

Objective:To study a new kind of operation for displaced intra-articular fractures of the calcaneus.

Methods:Of the 32 patients(22 male,10 female,average age 39.4 years),there were 35 displaced intra-articular fractures of the calcaneus.Among them,16 cases were of left foot,13 cases of right,3 cases of booth.The fractures were classified according to Sanders classification.Among them,21 fractures were of type Sanders III and 14 of type Sanders IV.All fractures were treated by internal fixation of plate and lag-screw with an extensive lateral approach.The plate was anatomic plate of calcaneus.

Results:All the patients were followed up for 4 to 62 months.The average period was 25 months.According to Maryland Foot Score,14 cases were of the excellent,8 cases of good,10 of fair and 3 of bad.The complications included 2 cases of superficial infection,1 case of deep infection and necrosis,4 arthritis of the subtalar joint,2 proneal tendonitis,2 malaligament of the hindfoot and 3 arthritis of the calcaneocuboid joint.There were significant different meaning of Bhler′s angle and Gissane′s angle between before and after operation.

Conclusion:It is an ideal method of treatment of displaced intra-articular fractures of the calcaneus by internal fixation of plate and lag-screw with an extensive lateral approach.The method can make patients early exercise after operation and reduce complication of fracture.
KEYWORDS:Calcaneus  Fractures  Fracture fixation,internal  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:刘立峰,蔡锦方,梁进,张强,王平山.严重移位的跟骨关节内骨折的手术治疗[J].中国骨伤,2007,20(5):328~329
英文格式:LIU Li-feng,CAI Jin-fang,LIANG Jin,ZHANG Qiang,WANG Ping-shan.Operative treatment of displaced intra-articular fractures of the calcaneus[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(5):328~329
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