CAJ | 학술논문

目的：探讨应用解剖型钛板内固定及致密植骨治疗跟骨关节内骨折的疗效。方法：选取2004年1月-2011年6月本院收治的53例（56足）跟骨关节内骨折患者，采取跟骨外侧入路切开复位，致密植骨支撑关节面骨碎块并用解剖型钛板内固定，围手术期常规应用抗生素防止感染，软组织挫伤严重、血运障碍者高压氧治疗。结果：随访8~32个月，根据Maryland足部评分系统统计疗效。总优良率为83.7%，Ⅳ型优良率为56.2%。结论：采用切开复位解剖型钛板内固定，钛板能有效维持跟骨的整体复位，恢复B?hler’s角、Gissane’s角和跟骨的高度、长度、宽度；骨缺损区致密植骨，关节面骨碎块能得到良好的支撑及复位，高压氧治疗可改善切口软组织局部缺氧状态、血供，促进受损组织再生及愈合，有效预防降低患部皮缘坏死，适时被动和主动功能锻炼，取得较好的临床疗效。
목적：탐토응용해부형태판내고정급치밀식골치료근골관절내골절적료효。방법：선취2004년1월-2011년6월본원수치적53례（56족）근골관절내골절환자，채취근골외측입로절개복위，치밀식골지탱관절면골쇄괴병용해부형태판내고정，위수술기상규응용항생소방지감염，연조직좌상엄중、혈운장애자고압양치료。결과：수방8~32개월，근거Maryland족부평분계통통계료효。총우량솔위83.7%，Ⅳ형우량솔위56.2%。결론：채용절개복위해부형태판내고정，태판능유효유지근골적정체복위，회복B?hler’s각、Gissane’s각화근골적고도、장도、관도；골결손구치밀식골，관절면골쇄괴능득도량호적지탱급복위，고압양치료가개선절구연조직국부결양상태、혈공，촉진수손조직재생급유합，유효예방강저환부피연배사，괄시피동화주동공능단련，취득교호적림상료효。
Objective:To investigate the anatomic titanium plate fixed and dense grafting in the treatment of intraarticular calcaneal fractures. Method:Fifty-three patients(56 feet)with intra articular calcaneus fracture in our hospital from January 2004 to June 2006 were selected.They were were treated by calcaneal lateral approach,open reduction,compact bone graft articular surface pieces and fixed by anatomical titanium plate in the peri operation period,the routine use of antibiotics to prevent infection,severe soft tissue injury,blood circulation disorders hyperbaric oxygen therapy. Result:The patients were followed up 8 to 32 months.According to the statistical efficacy of the Maryland Foot Score,excellent and good rate was 83.7%, type IV good rate of 56.2%.Conclusion:The fixed with open reduction and anatomic titanium plate,titanium can effectively maintain the overall reset of the calcaneus,restoration of B?hler’s angle,Gissane’s angle and calcaneal height,length,width;dense bone grafting of bone defects,joint facial bone fragments can get good support and reset,hyperbaric oxygen therapy can improve the incision of soft tissue local hypoxia,blood supply,promoting regeneration and healing of damaged tissue,and effective prevention is to reduce the affected area of skin flap necrosis,timely passive and active functional exercise,achieve better clinical efficacy.