CAJ | 학술논문

目的探讨移位跟骨关节内骨折手术治疗的临床疗效和手术技巧.方法自2007年11月-2009年10月采用切开复位内固定治疗40例45足移位跟骨关节内骨折,据Sander分型:Ⅱ型11侧,Ⅲ型31侧,Ⅳ型3侧,采用跟骨广泛外侧入路,应用可塑型AO钛质跟骨解剖钢板内固定,必要时术中植骨；术中侧位X线透视观察Bohler角及Gissane角,轴位观察跟骨宽度,Broden位透视观察后关节面的恢复情况.结果所有病例随访8～26个月,平均15个月,采用美国Maryland足部评分标准,评价手术效果,其中优21例,良14例,可4例,差1例,优良率为87.5％.结论跟骨关节内骨折手术治疗中,把握好手术时机,掌握骨折复位手术技巧,恢复跟骨结节角、距下关节面的平整和牢固固定是获得满意疗效的保证.
목적 탐토이위근골관절내골절수술치료적림상료효화수술기교.방법 자2007년11월-2009년10월채용절개복위내고정치료40례45족이위근골관절내골절,거Sander분형:Ⅱ형11측,Ⅲ형31측,Ⅳ형3측,채용근골엄범외측입로,응용가소형AO태질근골해부강판내고정,필요시술중식골；술중측위X선투시관찰Bohler각급Gissane각,축위관찰근골관도,Broden위투시관찰후관절면적회복정황.결과 소유병례수방8～26개월,평균15개월,채용미국Maryland족부평분표준,평개수술효과,기중우21례,량14례,가4례,차1례,우량솔위87.5％.결론 근골관절내골절수술치료중,파악호수술시궤,장악골절복위수술기교,회복근골결절각、거하관절면적평정화뢰고고정시획득만의료효적보증.
Objective To study the clinical effects and surgical technique of treatment for displaced intra-articular calcaneal fractures.Methods From November 2007 to October 2009,45 intraarticular calcaneal fractures in 40 patients were treated with open reduction internal fixation (ORIF).Extended lateral approach of calcaneal was used,there were 11 type Ⅱ,31 type Ⅲ and 3 type Ⅳ fractures found according to Sanders classification system.AO plastic titanic anatomic plates were used for fixation with bone grafting if necessary.Intra-operative radiographic evaluation was made to determine Bohlers angle and Gissanes angle on lateral view,calcaneal width on axial view,and joint surface reduction on Broden view.Results All patients were followed up for an average of 15 (ranged from 8 to 26) months.Clinical functional outcomes were graded using the Maryland foot score system.21 cases showed excellent results,while good in 14,fair in 4 and poor in 1,with an good rate of 87.5％.Conclusions In treating intraarticular calcaneal fractures,timing and surgical technique,restoring Bohlers angle and smooth subtalar articular surface,as well as stable fixation are the keys for satisfactory treatment efficacy.