解剖型钛板内固定治疗跟骨关节内骨折临床分析(1)
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[摘要] 目的：探讨跟骨关节内骨折切开复位+解剖型钛板内固定+架桥式植骨的技巧与疗效。方法：采用解剖型钛板治疗48例共56足SandersⅡ～Ⅳ型跟骨骨折(其中Ⅱ型28足、Ⅲ型21足、Ⅳ型7足)，Borden位透视观察后关节面的恢复情况，并测量术前、术后的Bohler′s角、Gissane′s角、Peries′s角的变化。结果：随访时间为6～36个月，术后Bohler′s角、Gissane′s角、Peries′s角明显恢复，术前、术后比较差异有高度统计学意义(P<0.01)，术后与健侧比较，差异无统计学意义(P>0.05)。按Maryland足部评分系统，总优良率为83.9%(47/56)。结论：解剖型钛板内固定+架桥式植骨治疗SandersⅡ～Ⅳ型跟骨骨折，固定可靠、并发症少、疗效满意，是治疗跟骨关节内骨折的有效方法。
[关键词] 钛板；内固定；架桥式植骨，跟骨骨折
[中图分类号] R683.42[文献标识码]A [文章编号]1673-7210(2011)08(a)-041-03
Clinical analysis of anatomic titanium plate internal fixation in treatment of calcaneus intra-articular fracture
RUAN Liangfeng, CHEN Yuan, MA Jianfan, LIU Haozhong
Department of Orthopaedics, the People＇s Hospital of Taishan City, Guangdong Province, Taishan 529200, China
[Abstract] Objective: To investigate the technique and curative effect of calcaneus intra-articular fracture treated with open reduction anatomic titanium plate internal fixation and bridging bone grafting. Methods: 48 cases (56 feet) sanders type Ⅱ-Ⅳ calcaneus intra-articular fracture (type Ⅱ 28 feet, type Ⅲ 21 feet, type Ⅳ 7 feet) were treated with open reduction anatomic titanium plate internal fixation and bridge bone grafting. The reconstruction of the articular facet was observed by X-ray examination at Borden position post-operatively. Also, the Bohler′s angle, Gissane′s angle and Peries′s angle were measured before and after operation. Results: The cases were followed up for 6 to 36 months. The Bohler′s angle, Gissane′s angle and Peries′s angle were all significantly recovered. The differences were statistically significant when compared with pre-operative data (P<0.01), but not statistically significant with the healthy side (P>0.05). According to the Maryland evaluation system, the total effective rate was 83.9% (47/56). Conclusion: It is an effective approach to treat Sanders type Ⅱ-Ⅳ calcaneus intra-articular fracture with anatomic titanium plate internal fixation and bridging bone grafting. The fixation is reliable, with few post-operative complications and promising curative effect.
[Key words] Titanium plate; Internal fixation; Bridging bone grafting; Calcaneus fracture ......
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