中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (39): 7331-7335.doi: 10.3969/j.issn.1673-8225.2011.39.028

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

克氏针撬拨结合钢板置入内固定与局部植骨治疗跟骨关节内骨折

陈晓明1,马华松1,刘玉增2,周建伟1,汪  东1   

  1. 1解放军306医院骨科,北京市100101
    2首都医科大学附属朝阳医院骨科,北京市100020
  • 收稿日期:2011-04-16 修回日期:2011-08-29 出版日期:2011-09-24
  • 作者简介:陈晓明★,男,1968年生,山西省太原市人,汉族,1992年解放军第三军医大学毕业,硕士,副主任医师,主要从事脊柱外科和创伤外科的研究。 bjchenxm@yahoo.com.cn

Intra-articular calcaneal fracture surgical treatment with Kirschner wire assisted plate fixation plus local bone graft

Chen Xiao-ming1, Ma Hua-song1, Liu Yu-zeng2, Zhou Jian-wei1, Wang Dong1   

  1. 1Department of Orthopedic Surgery, the 306 Hospital of Chinese PLA, Beijing  100101, China
    2Department of Orthopedics, Chaoyang Hospital, Capital Medical University, Beijing  100020, China
  • Received:2011-04-16 Revised:2011-08-29 Online:2011-09-24
  • About author:Chen Xiao-ming★, Master, Associate chief physician, Department of Orthopedic Surgery, the 306 Hospital of Chinese PLA, Beijing 100101, China bjchenxm@yahoo.com.cn

摘要:

背景:随着对后足部生物力学及跟骨骨折认识的深入,其临床治疗效果不断提高。
目的:观察切开复位钢板置入内固定治疗跟骨关节内骨折的效果。
方法:回顾性分析2004-02/2007-10解放军306医院骨科收治的跟骨关节内骨折患者46例52足,钢板置入前CT三维重建对52足跟骨关节内骨折进行分型。按Sander’s分型,分别对Ⅱ型20足,Ⅲ型16足,Ⅳ型16足跟骨关节内骨折采用切开复位克氏针撬拨结合钢板内固定、局部植骨治疗。
结果与结论:46例患者均获得随访,随访时间1~3年。所有患者无深部骨性感染,2例出现钢板置入处切口愈合不良,4例置入后出现创伤性关节炎表现。按Maryland足部评分标准评估效果,优38足,良9足,差3足,优良率90%。提示克氏针撬拨复位并钢板置入内固定与植骨治疗跟骨关节内骨折疗效满意。

关键词: 跟骨钢板, 跟骨关节内骨折, 侧方入路, 内固定, 撬拨复位

Abstract:

BACKGROUND: With the in-depth understanding of foot biomechanics and calcaneal fracture, the curative effect on intra-articular calcaneal fracture continues to be improved.
OBJECTIVE: To investigate the effect of nonlocking compression plates on intra-articular calcaneal fractures.
METHODS: We performed 52 osteosynthesis (46 patients) of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Nonlocking calcaneal plates were performed in the 46 patients. Preoperatively, all patients were checked by three-dimensional CT. According to Sander’s type, there were 20 feet of Ⅱ fracture, 16 of Ⅲ fracture, and 16 of Ⅳ fractures. Reconstruction of the calcaneal shape was attempted. During operation, we performed Kirschner wire assisted subtalar distraction bone block and osteosynthesis with lateral-wall compression plate insertion in all cases. The patients were evaluated by the Maryland Scale.
RESULTS AND CONCLUSION: All 46 patients were followed up for 1-3 years. Poor wound healing was in 2/46 cases, and traumatic arthritis in 4 cases. No patient had deep osseous infection. According to the Maryland Scale, good was in 38 feet, fair in 9 feet and poor in 3 feet, with an excellent rate of 90%. Kirschner wire assisted plate fixation plus local bone graft is satisfied in the treatment of intra-articular calcaneal fractures.

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