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1、解剖型钛板内固定治疗跟骨关节内骨折临床分析［摘耍］冃的: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(其屮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Bohlerzs角、Gissane^s角、Peries's角的变化。结果：随访吋间为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
2、.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)o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冇效方法。［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11673-7210(2011)08(a)-041-03Clinicalanalysisofanatomictitaniumplateinternalfixat
3、ionintreatmentofcalcaneusintra-articularfractureRUANLiangfeng,CHENYuan,MAJianfan,LIUHaozhongDepartmentofOrthopaedics,thePeople'sHospitalofTaishanCity,GuangdongProvince,Taishan529200,China［Abstract］Objective:Toinvestigatethetechniqucandcurativeeffectofcalcaneusi
4、ntra-articularfracturetreatedwithopenreductionanatomictitaniumplateinternalfixationandbridgingbonegrafting.Methods:48cases(56feet)sanderstypeIITVcalcaneusintra-articularfracture(typeI【28feet,typeIII21feet,typeIV7feet)weretreatedwithopenreductionanatomictitanium
5、plateinternalfixationandbridgebonegrafting・Thereconstruct!onofthearticularfacetwasobservedbyX-rayexaminationatBordenpositionpost-operatively・Also,theBohler'sangle,GissanezsangleandPeries1sangleweremeasuredbeforeandafteroperation.Results:Thecaseswerefollowedupfo
6、r6to36months-TheBohler'sangle,Gissanc,sangleandPcries/sanglewereallsignificantlyrecovered.Thedifferencoswerestatisticallysignificantwhencomparedwithpre-operativedata(P<0.01),butnotstatisticallysignificantwiththehealthyside(P>0.05).AccordingtotheMarylandevaluati
7、onsystem,thetotaleffectiveratewas83.9%(47/56).Conelusion:ItisaneffectiveapproachtotreatSanderstypeII-IVcalcaneusintra-articularfracturewithanatomictitaniumplateinternalfixationandbridgingbonegrafting.Thefixationisreliable,withfewpost-operativecomplicationsandpr
8、omisingcurativeeffect.［Keywords］Titaniumplate;Internalfixation;Bridgingbonegrafting;Calcaneusfracture跟骨骨折是最常见的附骨骨折，占附骨骨折的60%,占全身骨折的2%,其中85%〜90%为关节内骨折［1］，20%〜45%伴有跟骰关节损伤。跟骨及周
