Wu Yong, Yang Ming-hui, Wang Jin-hui, Wang Man-yi, Sun Zhi-wen
Department of Orthopedics and Traumatology, Jishuitan hospital, Beijing 100035, China.
Zhonghua Wai Ke Za Zhi. 2005 Jun 15;43(12):788-91.
To evaluate the results of intra-articular calcaneal fractures treated with open reduction and internal fixation.
Thirty-five displaced intra-articular calcaneal fractures in 34 patients were treated with open reduction and internal fixation from August 2001 to April 2003. Fracture classification was based on Sanders classification. Extended lateral approach, and fixed the fractures with AO titanium plate for calcaneus were performed. Bone graft was used in selected patients. Thirty-five fractures in thirty-four patients were evaluated using radiographic examinations and ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS). Average follow-up was 18.3 months (range from 12 to 32 months).
There were 30 type II fractures and 5 type III fractures. Average Böhler's angle was 5.6 degrees preoperatively and 28.2 degrees finally. Roentgenographic evaluation of calcaneal body dimensions showed restoration of heel height (97.7%) to virtually normal. Anatomic or near anatomic reductions were obtained in 80% of the cases. The average score was 88.1 for type II fractures, and 78.8 for type III fractures. Excellent or good clinical results occurred in 82.8% type II fractures, and 60.0% type III fractures. The overall excellent or good rate was 79.4%.
From the results, open reduction and internal fixation for Sanders type II and type III fractures are recommended.
评估切开复位内固定治疗跟骨关节内骨折的效果。
2001年8月至2003年4月，对34例患者的35例移位跟骨关节内骨折行切开复位内固定治疗。骨折分类采用Sanders分类法。采用延长外侧入路，用AO跟骨钛板固定骨折。部分患者使用了植骨。采用影像学检查及美国足踝外科协会（AOFAS）的踝后足临床评分系统对34例患者的35处骨折进行评估。平均随访18.3个月（12至32个月）。
Ⅱ型骨折30例，Ⅲ型骨折5例。术前平均Böhler角为5.6°，最终为28.2°。跟骨体尺寸的X线评估显示足跟高度恢复至接近正常（97.7%）。80%的病例获得了解剖复位或近解剖复位。Ⅱ型骨折平均评分为88.1分，Ⅲ型骨折为78.8分。Ⅱ型骨折82.8%获得优良临床效果，Ⅲ型骨折为60.0%。总体优良率为79.4%。
从结果来看，推荐对SandersⅡ型和Ⅲ型骨折行切开复位内固定治疗。
