解剖型钛板内固定治疗跟骨关节内骨折临床分析.docx

解剖型钛板内固定治疗跟骨关节内骨折临床分析[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（P0.05）。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）-041-03Clinicalanalysisofanatomictitaniumplateinternalfixationintreatmentofcalcaneusintra-articularfractureRUANLiangfengCHENYuanMAJianfanLIUHaozhongDepartmentofOrthopaedicsthePeople＇sHospitalofTaishanCityGuangdongProvinceTaishan529200China[Abstract]Objective:Toinvestigatethetechniqueandcurativeeffectofcalcaneusintra-articularfracturetreatedwithopenreductionanatomictitaniumplateinternalfixationandbridgingbonegrafting.Methods:48cases(56feet)sanderstypeⅡ-Ⅳcalcaneusintra-articularfracture(typeⅡ28feettypeⅢ21feettypeⅣ7feet)weretreatedwithopenreductionanatomictitaniumplateinternalfixationandbridgebonegrafting.ThereconstructionofthearticularfacetwasobservedbyX-rayexaminationatBordenpositionpost-operatively.AlsotheBohler′sangleGissane′sangleandPeries′sangleweremeasuredbeforeandafteroperation.Results:Thecaseswerefollowedupfor6to36months.TheBohler′sangleGissane′sangleandPeries′sanglewereallsignificantlyrecovered.Thedifferenceswerestatisticallysignificantwhencomparedwithpre-operativedata(P0.05).AccordingtotheMarylandevaluationsystemthetotaleffectiveratewas83.9%(47/56).Conclusion:ItisaneffectiveapproachtotreatSanderstypeⅡ-Ⅳcalcaneusintra-articularfracturewithanatomictitaniumplateinternalfixationandbridgingbonegrafting.Thefixationisreliablewithfewpost-operativecomplicationsandpromisingcurativeeffect.[Keywords