Zhou Yu-Kuan, Zhang Biao, Hu Ting-Jun, Li Xiao-Fu
Department of Orthopaedics, People's Hospital of Wuhe, Wuhe 233300, Anhui, China.
Zhongguo Gu Shang. 2010 Jun;23(6):463-5.
To investigate the operative treatment of displaced intra-articular calcaneal fracture by lateral minimally invasive approach reduction and internal fixation.
During January 2006 to September 2009, 30 cases (31 feet) of displaced intra-articular calcaneal fracture were treated by open reduction and hollow screws internal fixation through lateral minimally invasive approach from the fibular tip to the basement of the fourth metatarsal foot (Sanders II in 21 feet, Sanders III in 8 feet, Sanders IV in 2 feet), including 23 males and 7 females with an average age of 36.5 years ranging from 18 to 60 years.
The 31 feet of 30 patients were followed-up for from 3 to 24 months (14 months in average). There was no soft tissue complications such as infected incision, skin necrosis, poor wound healing, and sural nerve injury. X-ray films of 25 feet after the operations showed well reduction of articular surface and satisfactory shape on calcaneal; 6 feet showed roughly normal shape. Based on the Maryland grading system, 6 feet were excellent, 20 feet good and 5 feet fair.
The lateral minimally invasive approach is a good option for calcaneal fracture of Sanders II and III, because of its less damages to soft tissue and fewer complications. It could also provide excellent exposure of articular surface.
探讨采用外侧微创入路复位内固定治疗移位性跟骨关节内骨折的手术方法。
2006年1月至2009年9月，采用外侧微创入路（从腓骨尖至第4跖骨基底）切开复位空心螺钉内固定治疗30例（31足）移位性跟骨关节内骨折（SandersⅡ型21足，SandersⅢ型8足，SandersⅣ型2足），其中男23例，女7例，年龄18～60岁，平均36.5岁。
30例患者的31足均获随访，随访时间3～24个月，平均14个月。未出现切口感染、皮肤坏死、伤口愈合不良及腓肠神经损伤等软组织并发症。术后25足X线片显示关节面复位良好，跟骨形态满意；6足形态大致正常。根据Maryland评分系统，优6足，良20足，可5足。
外侧微创入路治疗SandersⅡ、Ⅲ型跟骨骨折对软组织损伤小，并发症少，能良好显露关节面，是一种较好的手术方法。
