Laughlin R T, Carson J G, Calhoun J H
Department of Orthopedic Surgery, Wright State University, Dayton, Ohio 45409, USA.
Foot Ankle Int. 1996 Feb;17(2):71-8. doi: 10.1177/107110079601700203.
From January 1992 to August 1993, 59 calcaneal fractures in 48 patients were treated. Thirty-three fractures in 31 patients were displaced intra-articular fractures and were treated with open reduction and internal fixation through an extensile lateral approach with the Galveston plate (Smith and Nephew, Richards, Memphis, TN). Complete radiographs and CT scans were available for 32 of the fractures. The CT scan classification of Sanders was used. The distribution of the fractures was: IIA, N = 17; IIB, N = 2; IIC, N = 2; IIIAB, N = 7; IIIAC, N = 2; IV, N = 2. Sixteen (50%) had calcaneocuboid joint involvement. Preoperative and postoperative radiographic measurements of Bohler's angle, Gissane's angle, talocalcaneal angle, and Achilles tendon fulcrum distance were made. Clinical follow-up on 23 fractures in 22 patients at an average of 21 months is presented. Seventy percent of the patients have no pain or only occasional pain not requiring medication. Using the Maryland Foot Score for assessment, 78% of the patients had a good or excellent result. The Galveston plate was useful for maintaining reduction of intra-articular calcaneus fractures treated operatively and provided results comparable to other reported series.
1992年1月至1993年8月，对48例患者的59处跟骨骨折进行了治疗。31例患者的33处骨折为关节内移位骨折，采用外侧扩大入路加用加尔维斯顿钢板（史赛克公司，理查兹，田纳西州孟菲斯）进行切开复位内固定治疗。32处骨折均有完整的X线片和CT扫描资料。采用桑德斯CT扫描分类法。骨折分布情况为：IIA型，N = 17；IIB型，N = 2；IIC型，N = 2；IIIAB型，N = 7；IIIAC型，N = 2；IV型，N = 2。16处（50%）骨折累及跟骰关节。分别在术前和术后对跟骨结节角、跟骨交叉角、距跟角和跟腱支点距离进行X线测量。现报告对22例患者的23处骨折进行平均21个月的临床随访结果。70%的患者无疼痛或仅有偶尔疼痛，无需用药。采用马里兰足部评分系统进行评估，78%的患者结果为良好或优秀。加尔维斯顿钢板对于手术治疗的关节内跟骨骨折维持复位很有用，其治疗结果与其他报道的系列相当。
