CAJ | 학술논문

目的：探讨自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗Sanders Ⅲ，Ⅳ型跟骨骨折的疗效。方法对28例（28足） SandersⅢ，Ⅳ型跟骨骨折均采用切开复位可塑形钛板固定联合自固化磷酸钙人工骨治疗，跟骨外侧放置可塑形钛板，术后测量Bohler＇s 角、Gissane＇s角，评价跟骨骨折的复位情况。结果所有患者均得到随访，术后皮缘坏死2例，腓肠神经损伤1例。术后6个月Bohler＇s 角20足≥35°，8足≥30°，Gissane角全部恢复至正常范围，轴位片上未见跟骨内翻畸形。骨折愈合时间2～3个月，所有患者参考Maryland足部评分系统，治疗效果如下：优15足，良5足，可3足，差2足，总优良率为83．7％，Ⅳ型优良率为56．2％。结论采用自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗SandersⅢ，Ⅳ型跟骨骨折手术方法简单，疗效满意。
목적：탐토자고화린산개인공골식골연합가소형태판내고정치료Sanders Ⅲ，Ⅳ형근골골절적료효。방법대28례（28족） SandersⅢ，Ⅳ형근골골절균채용절개복위가소형태판고정연합자고화린산개인공골치료，근골외측방치가소형태판，술후측량Bohler＇s 각、Gissane＇s각，평개근골골절적복위정황。결과소유환자균득도수방，술후피연배사2례，비장신경손상1례。술후6개월Bohler＇s 각20족≥35°，8족≥30°，Gissane각전부회복지정상범위，축위편상미견근골내번기형。골절유합시간2～3개월，소유환자삼고Maryland족부평분계통，치료효과여하：우15족，량5족，가3족，차2족，총우량솔위83．7％，Ⅳ형우량솔위56．2％。결론채용자고화린산개인공골식골연합가소형태판내고정치료SandersⅢ，Ⅳ형근골골절수술방법간단，료효만의。
[ ABSTRACT] Objective To investigate the curative effect of Sanders Ⅲ,Ⅳ calcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate.Methods Twenty-eight cases(28 feet) SandersⅢ,Ⅳcalcaneal frac-tures adopted open reduction with shaping titanium plate internal fixation combined with autosetting calcium phosphate cement bone-grafting, the shaping titanium plate were placed at the outward of calcaneus,reset evaluation of calcaneal fractures by measuring Bohler's Angle,Gis-sane's Angle in postoperation.Results All patients were followed up,postoperative skin necrosis in 2 cases and sural nerve injury in 1 case. After 6 months,Bohler's Angle in 20 foot≥35°,in 8 foot≥30°,Gissane Angle fully recovered to normal range and calcaneal varus deformity on axial were not seen.Fracture healing time was 2~3 months,according to Maryland foot scoring system,treatment effects of all patients were as follows:excellent in 15 feet,good in 5 feet,normal in 3 feet and poor in 2 feet,the total excellent and good rate was 83.7%,the excel-lent and good rate ofⅣtype was 56.2%.Conclusion The treatment of SandersⅢ,Ⅳcalcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate is simple and its curative effect is satisfied.