切开复位克氏针结合跟骨重建钢板内固定＋植骨术治疗跟骨骨折

目的探讨切开复位克氏针结合跟骨重建钢板内固定植骨术治疗跟骨关节内骨折的疗效。方法对38例（38足）SandersⅢ型、Ⅳ型跟骨骨折均采用切开复位克氏针结合跟骨重建钢板内固定＋植骨术治疗,术中克氏针维持塌陷的关节面复位,跟骨外侧缘放置重建钢板和植骨,术后测量Bhler角和Gissane角,评价跟骨骨折的复位情况。结果患者均无感染和皮肤坏死,复查X线片提示Bhler角和Gissane角分别为24°～42°和98°～137°,骨折均达骨性愈合,愈合时间10～16（13±3）周,按Maryland足部评分系统评价术后功能：优26足,良10足,差2足,优良率94.7%。结论采用切开复位克氏针结合跟骨重建钢板内固定＋植骨术治疗SandersⅢ型、Ⅳ型跟骨骨折手术方法简单,疗效满意。

Open reduction and internal fixation for treatment of intra-articular fracture of calcaneus with Kirscher wire and calcaneus reconstruction plate

Objective To investigate the surgical treatment and clinical effect of the intra-articular fracture of calcaneus by open reduction and internal fixation with Kirscher wire and reconstruction plate with bone-grafting.Methods 38 cases with calcaneus intra-articular fracture were treated with Kischer wire combined with reconstruction plate and bone-grafting.The results of reduction were evaluated according to measurement of Bhler′s angle and Gissane′s angle after operation.Results All cases got union in 1016 （13±3）weeks with no infection and skin necrosis.The Bhler and Gissane angles were restored to 24°42° and 98°137°.According to Maryland foot score,the results were excellent in 26 cases,good in 10,and poor in 2,and the total excellent and good rate was 94.7%.Conclusions The surgical treatment of calcaneus intra-articular fracture with reconstruction plate and Kirscher wire and bone-graft is simple and reliable.