摘要
Abstract
Objective To explore the clinical effect of anatomic locking plate open reduction and internal fixation without bone graft for treatment of Sanders type Ⅲ and Ⅳ caleaneal fracture. Methods A retrospec-tive analysis of 60 patients with Sanders III and IV type of calcaneal fracture was performed. Thirty-two patients in the observation group were treated with calcaneal lateral surgical approach and anatomic locking plate inter-nal fixation without bone graft. Twenty-eight cases in the control group were treated with lateral calcaneal ap-proach, autogenous iliac bone graft, open reduction and internal fixation. Postoperative observation and records of the occurrence of related complications were performed. During follow-up, X-ray was used, to measure and compare the imaging B?hler angle, Gissane angle calcaneal width and height of calcaneus changes before and af-ter surgery. Postoperative surgical treatment effect was evaluted using Maryland foot function comprehensive as-sessment scoring system. Results Patients in two groups were follow-up from 6 to 12 months (average 8 months). There was no plate loosened, screws fractured and other complication. The control group had 2 patients of incision effusion, 1 case of skin necrosis, which were symptomatic healed after dressing. X-ray showed cal-caned fractures in all patients were healed 7~11 weeks (average 9 weeks) after operation. All patients could walk 6 months after operation. B?hler angle, Gissane angle, height of calcaneus and calcaneal width in two groups at the last follow-up were significantly improved than preoperation. At the end of the follow-up, 32 patients in the observation group had an average Maryland foot score of (87.1 ± 5.9) points. The excellent rate in observation group was 90.6%. In the control group, the average Maryland foot function score was (85.9±6.3) points. The ex-cellent rate was 85.7%. Conclusion Anatomic locking plate open reduction and internal fixation without bone graft for the treatment of Sanders type III, IV calcaneal fractures has good fixation stability, better shape and calcaneus foot function recovery, has few-er complication, and significantly reduces bone grafting and nonunion rate after fixation of bone infection.关键词
跟骨骨折/解剖复位/钢板/内固定术/植骨Key words
Calcaneal fractures/anatomical reduction/locking plate/internal fixation/bone graft分类
医药卫生
