| 跟骨骨折手术治疗中后关节面的处理 |
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Received:December 29, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 徐鹏武 |
XU Peng-wu |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
xpw118@163.com |
| 乔林 |
QIAO Lin |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
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| 张树明 |
ZHANG Shu-ming |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
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| 刘春生 |
LIU Chun-sheng |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
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| 张巍 |
ZHANG Wei |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
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| 徐庆蕾 |
XU Qing-lei |
解放军第二炮兵总医院骨科,北京 100088 |
Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA,Beijing 100088,China |
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| 期刊信息：《中国骨伤》2010年23卷，第6期，第459-461页 |
| DOI：10.3969/j.issn.1003-0034.2010.06.021 |
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目的：探讨跟骨骨折治疗中后关节面的复位及维持固定的相关问题。
方法：自2004年9月至2008年9月，31例38足累及后关节面移位的跟骨骨折，其中男24例，女7例；年龄20～65岁，平均39.6岁。术前均行CT扫描及三维重建，按Sanders分类:Ⅱ型骨折22足，Ⅲ型骨折14足，Ⅳ型骨折2足。均经可延长的外侧“L”形入路切开复位钢板结合斯氏针内固定治疗。
结果：所有患者均获随访，时间12～36个月，平均25个月。骨折均愈合，无皮瓣坏死。按Maryland足功能评分标准评价手术效果:术后总评分(96.2±8.8)分，优32足，良4足，可2足。
结论：术中使用Broden位X线监控后关节面复位情况，使用钢板结合斯氏针内固定能很好维持固定后关节面的稳定，为功能恢复提供良好的条件。 |
| [关键词]:跟骨 骨折 关节 骨折固定术,内 |
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| Surgical treatment of calcaneus fracture involving posterior subtalar articular facet |
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Abstract:
Objective: To investigate the methods of reduction and stable fixation for the treatment of calcaneus fracture involving posterior subtalar articular facet.
Methods: From September 2004 to September 2008,31 cases(38 feet) of calcaneus fracture involving posterior subtalar articular facet were treated with open reduction and plate fixation through L incision. There were 24 males and 7 females,with an average age of 39.6 years ranging from 20 to 65 years. All patients underwent systematic CT-scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 22 of typeⅡ,14 of typeⅢ,2 of type Ⅳ.
Results: All cases were followed up for from 12 to 36 months with an average of 25 months,and all the fractures healed without skin flap necrosis. According to the Maryland foot scoring,the total score was(96.2±8.8) on average,the results were excellent in 32 feet,good in 4 feet,fair in 2 feet.
Conclusion: The replaecment of the posterior articular facet by X-ray control of Broden and open reduction and internal fixation with calcaneus plate and Schanz-Screw during the operation can keep stable of articular facet,and promote early rehabilitation of calcaneus fracture affected with subtalar joint. |
| KEYWORDS:Calcaneus Fractures Joints Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐鹏武,乔林,张树明,刘春生,张巍,徐庆蕾.跟骨骨折手术治疗中后关节面的处理[J].中国骨伤,2010,23(6):459~461 |
| 英文格式: | XU Peng-wu,QIAO Lin,ZHANG Shu-ming,LIU Chun-sheng,ZHANG Wei,XU Qing-lei.Surgical treatment of calcaneus fracture involving posterior subtalar articular facet[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(6):459~461 |
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