累及距下关节跟骨骨折并发症的防治

目的探讨累及距下关节的跟骨骨折并发症的防治。方法回顾性分析2003年1月至2008年7月我院收治累及距下关节的跟骨骨折52例63足,按Sanders分型,Ⅰ型6足,Ⅱ型13足,Ⅲ型26足,Ⅳ型18足。采用保守治疗6足,撬拨复位空心拉力螺钉固定、管型石膏托外固定8足,切开复位跟骨钢板内固定加自体髂骨植骨39足,钢板内固定未植骨10足。结果63足均获得随访,平均随访23个月。按M ary land足部功能评分系统进行疗效评定,优20足,良36足,可5足,差2足,优良率88.9%。出现皮肤坏死3例,浅表感染2例,腓肠神经损伤1例,腓骨肌腱炎2例,创伤性骨关节炎4例。结论累及距下关节的跟骨骨折应根据骨折类型选择恰当的治疗方案,可有效减少并发症,获得满意的疗效。

Prevention and Treatment of the Complications of Calcaneum Fracture Subtalar Joint

Objective To evaluate the complication prevention countermeasure of calcaneum fracture implicates the subtalar joint.Methods review analysis 63 cases calcaneum fracture subtalar joint.according to Sanders classification,there are 6 feet ofⅠ,13 feet of Ⅱ,26 feet of Ⅲ,18 feet of Ⅳ,the treatment：t 6 feet ate fixed with the gypsum,8 feet are dialed to replacement after the skid the hollow pulling force screw retention Canada cast the gypsum to hold fixedly,39 feet are treated with internal fixtion with calcaneu calcaneum steel plate and Planted the bone from the body qia bone, 10 feet are not planted. Results All the eases are followed up with average of 23 months,By the Maryland foot function grading system,excellent in 20 feet,good in 36,fair in 5 and poor in 2,the rate of good to excellent was 88. 9%. All the cases,Skin necrosis 1 foot,the shallow table infects 2,fei intestines neurotrosis 1 example,fibula myotenositis 2 and 4 casea wound osteoarthritis. Conclusion According to bone fracture type chooseing appropriate therapeutic schedule to treat the calcaneum bone fracture,can reduce the complication effectively,obtains satisfactory effect.