【摘要】目的 探讨手术联合熏蒸治疗跟骨关节内骨折的适应证及优缺点。方法 2005年12月至2010年12月，在关节镜辅助下采用经皮螺钉内固定治疗单侧跟骨关节内骨折12例，男7例，女5例；年龄23～61岁，平均36.8岁；右侧8例，左侧4例；高处坠落伤11例，车祸伤1例。SandersⅡ型8例(ⅡA型1例，ⅡB型5例，ⅡC型2例)，Ⅲ型4例(ⅢAB型2例，ⅢAC型1例，ⅢBC型1例)。结果 9例获得随访，随访时间10～25个月，平均17.4个月。按Maryland足分系统评价术后功能，其评分为82～100分，平均92.5分，优6例，良3例。所有获得随访患者无一例发生骨折再移位等并发症，足外形良好，能够正常穿鞋，无明显跛行。结论 此种手术联合熏蒸治疗适用于SandersⅡ型和部分SandersⅢ型跟骨骨折的治疗，可获得良好的复位和可靠的固定，并明显降低软组织损伤等并发症的发生率，是一种可行、有效的微创治疗方法。

    【关键词】骨折固定术 跟骨骨折 熏蒸散

    中图分类号：R683文献标识码：B文章编号：1005-0515(2011)12-089-02

    【Abstract】Objective To investigate the surgical treatment of combined intra-articular calcaneal fractures fumigation indications and advantages and disadvantages. Methods from December 2005 to December 2010, arthroscopic assisted percutaneous screw fixation of unilateral intra-articular calcaneal fractures in 12 patients, 7 males and 5 females; aged 23 to 61 years, mean 36.8 years; right side in 8 cases, left in 4 cases; falls injury in 11 cases, car accident injuries in 1 case. Sanders Ⅱ 8 cases (Ⅱ A 1 case, Ⅱ B in 5 cases, Ⅱ C type 2 cases), Ⅲ type 4 cases (Ⅲ AB type 2 cases, Ⅲ AC type 1 cases, Ⅲ BC 1 case). Results 9 patients were followed up for 10 to 25 months, an average of 17.4 months. According to the Maryland foot subsystems were evaluated, and its score of 82 to 100 points, an average of 92.5 points, excellent in 6 cases, good in 3 cases. All patients were followed up without a case of complications such as fracture re-displacement, good enough shape to normal shoes, no obvious limp. Conclusion This surgical treatment of combined fumigation for Sanders Ⅱ type and some Sanders Ⅲ type calcaneal fractures, get a good reduction and reliable fixation, and soft tissue injury significantly reduced the incidence of complications, is a feasible and effective minimally invasive treatment. ......