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1、·提要目的：通过对异形锁定钢板内固定加植骨术治疗SandersⅢ型、Ⅳ型跟骨骨折的临床观察，总结其疗效。方法：病例选自2010年3月至2011年3月山东中医药大学附属医院骨科病房，将符合标准的34例(40足)进行回顾性分析。采用跟骨外侧“L”形切口，锁定钢板内固定并植骨。术后积极随访12～18个月，平均14个月。通过对手术后Bohler’s角、Gissane’s角的测量，骨折愈合时间评价，患足Maryland足部功能评分评价，得出该种手术方式的临床疗效。结果：34例(40足)跟骨骨折切口31足愈合良好，2足刀口边缘坏死经换药后愈
2、合,1足刀口延迟愈合。骨折全部愈合，平均愈合时间15.6周。术后复查X线和（或）CT显示骨折愈合良好，测量Bohler’s角、Gissane’s角恢复满意，跟骨的高度、宽度、长度得到显著恢复。Maryland足部功能评分优例20良11例可8例差1例，总优良率77.50%。结论：加强围手术期管理、选择合适手术时机，掌握必要的手术技巧，异形锁定钢板内固定加植骨术治疗SandersⅢ、Ⅳ型跟骨骨折可取得良好的效果。关键词跟骨骨折；Sanders分型；异形锁定钢板；植骨···Shapedlockingplatefixationandbo
3、negraftofcalcanealfractureofSandersIII,IVclinicalobservationSpeciality:OrthopedicsofTCMAuthor:JiangZeweiTutor:Professor:MengKaiAbstractObjective:special-shapedlockingplateandbonegraftinthetreatmentofSanders,IIItypeIV,typecalcanealfractures,clinicalobservations,andsum
4、marizeitsefficacy.Method:ThecaseselectedfromHospitalofShandongUniversityofTraditionalChineseMedicinesinceMarch2010toMarch2011,meetthestandards34cases(40feet)wereretrospectivelyanalyzed.Lateralcalcaneal"L"shapedincision,thelockingplatefixationandbonegrafting.Positivef
5、ollow-upafter12to18months,anaverageof14months.BytheopponentspostoperativeBohler'sangle,Gissane'sanglemeasurement,fracturehealingtimeofevaluation,theevaluationoffootfunctionscoreoftheaffectedfootMaryland,cometotheclinicalefficacyofthesurgicalapproach.Results:34cases(4
6、0feet)ofcalcanealfracturesincisionhealedwell31feet,two-footbladeedgenecrosishealedafterchangingdressing,afootknife-edgedelayhealing.Allfractureshealed,andtheaveragehealingtimeof15.6weeks.AfterreviewoftheX-raymeasuringBohler'sangle,angleGissane'ssatisfactory.Marylandf
7、ootscoreexcellentcasesof20good11casesof8casesandpoorin1case,thetotalrateof77.50%.Conclusions:Perioperativemanagement,selecttheappropriatetimingofsurgery,toacquirethenecessarysurgicaltechniques,special-shapedlockingplatefixationandbonegraftingtreatmentSanders,III,IV-t
8、ypecalcanealfracturescanachievegoodresults.KeywordsCalcanealfractures；Special-shapedsteel；Sanderstypes；Bonegraft···目录引言............
