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1、切开复位内固定治疗跟骨骨折摘要:目的:探讨跟骨锁定板(lockingplate,LCP)治疗跟骨关节内骨折手术时机、手术方法和临床效果。方法:采用扩大形外侧入路,切开复位LCP内固定治疗跟骨关节内骨折,患者31例,男30例(单侧29例,双侧1例),女1例,供32足,年龄18〜50岁,平均32岁,骨折采用Sanders分型,32足均为闭合骨折。结果:26例获得随访,随访时间6〜24个月,5例失访。术前B?hler角<10°,术后20°〜40°;Gissane角,术后120。〜145。;切口25足甲级愈合,1足乙级愈合
2、。术后无撞击,无神经血管损伤等并发症,无骨折移位及内固定失败等情况。按照Maryland足部评分评估,术后功能评价,优13良12中2差0,优良率92.6%0结论:选择合适的手术时机,精细的术中操作,应用LCP治疗跟骨关节内骨折可获得满意的临床效果,利于患者功能恢复。关键词:跟骨骨折;锁定板;骨折固定术Abstract:ObjectiveToevaluatethetime,methodandtheclinicaloutcomeofoperativemanagementofdisplacedintra-articularfr
3、acturesofthecalcaneuswithcalcaneallockingplate(LCP)・MethodsThirty-twofracturesin31patients(30maleincluding1bilateral,1female)weretreatedwithopenreductionandinternalfixation(ORIF)ofintra-articularcalcanealfracturesusingLCPthroughanextendedL-shapedlateralapproach.T
4、heaverageageofthirty-onepatientswas32years(range,18to50years)・Allfractureswerecloseinjuries,andSandersclassificationwasdetermined・ResultTwenty-sevenofthesefracturesin26patientswerefollowedup.Allfractureshadgreaterthanthreemonthsfollow-up,(range6to12),andthesehave
5、beenfollowedtofTacturehealing.TheBohleranglewasrecoveredfromless10°preoperativeto20°〜40°postoperativeandtheGissaneanglewasrecoveredfromless100°to120°〜145°.Nopatientsustainedlateralimpingementsyndromeorsofttissuecomplications.Withpostoperativeplainradiographs,ther
6、eductionoffractureswasmaintened,andallofinternalfixationweresuccess.AccordingtoMarylandetalfootscoreexecel1ent/good92.6%,fair7.4%.ConclusionTheapplicationtheLCPthroughextendlateralapproachisprovedtobeaneffectivetreatmentfordisplacedintra-articularcalcanealfractur
7、ebygraspingcorrectopportunityofoperationandperfectoperativetechnique,offeringthecombinationofgoodreductionandearlyrehabi1itation.Keywords:Calcanealfracture;Fracturefixation;Lockingplate跟骨骨折大多是由于数高处坠落伤形成跟距轴向爆力所致,多发生在青壮年。跟骨关节内移位骨折采用保守治疗通常无法恢复正常解剖形态及关节面的平整,常导致跟骨畸形、疼
8、痛、活动功能障碍、外侧撞击等并发症[1、2]0目前手术治疗跟骨关节内骨折的入路、方法较多,但多以外侧入路、切开复位内固定的报道较多[3],我们应用跟骨锁定板采用个侧扩大形入路切开复位内固定治疗跟骨关节内骨33足,取得良好的临床效果。资料与方法一、一般资料木组采用跟骨锁定板通过扩大形外侧入路治疗跟骨关节内移位骨折患者3