海南医科大学学报

目的:探讨跟骨关节内骨折钛钢板内固定治疗的疗效及减少并发症的策略。方法:47例52侧跟骨关节内骨折采用外侧扩大"L"型切口使用跟骨钛钢板固定并对术后并发症进行分析。结果:47例52侧跟骨关节内骨折经随访6~36个月,平均17个月,按Maryland评分,优良率为86.5%。B hler角由术前平均5度(-10度~15度)恢复到术后平均28度(5度~45度),随访中有2例后关节面发生塌陷,B hler角5度,行走严重疼痛。切口坏死2例,切口感染1例,无腓肠神经损伤。并发症发生率9.6%。结论:跟骨关节内骨折采用钛钢板内固定,术中掌握复位和固定的关键点,正确选择手术时机和切口无创操作对Sanders 2、3型骨折能取得满意的疗效。

Objective: To explore titanic alloy plate internal fixation for intracalaneal joint fracture and prevention of complication.Methods: Fifty-two patients with intracalaneal joint fracture were treated with titanic alloy plate internal fixation through external incision of expanded "L" pattern and the results were analyzed.Results: Fifty-two patients underwent the operation were follow-up 6～36 months,mean 17 months,assessed with Maryland Scale,satisfactory rate was 86.5%,angle of Bhler recovered from average 5°(-10°～15°)before treatment to average 28°(5°～45°)after the operation;2 cases occurred posterior joint face collapse,the angle of Bhler was 5°,patients felt severe pain when walking.2 cases occurred necrosis of incision,1 case occurred infection of incision,none occurred gastrocnemius nerve lesion.The incidence of complication was 9.6%.Conclusion: Titanic alloy plate internal fixation for intracalaneal joint fracture of SandersⅡ,Ⅲ has high effect and little complication;the keys to success are to command indication,practice mininvasive incision,proper reduction and fixation.