跟骨骨折植骨+内固定治疗的选择比较

摘要

Objective:To study and compare the clinical effect of calcaneus bone internal fixation in the treatment of clinical operation of planting different fracture.Method:112 cases according to Sanders classification method of typeⅢabove calcaneal fractures were selected,47 cases of typeⅢwere treated with simple bone graft or internal fixation,65 cases were treated with bone grafting and internal fixation(20 cases of type Ⅲ,45 cases of type IV).Result:112 cases were followed up for 6-8 months,all got bony union in 14-22 weeks with good joint functional recovery.In simple bone graft or internal fixation group,the results were excellent in 24 cases,good in 15 cases,medium in 6 cases,and poor in 2 cases;In bone grafting and internal fixation group,the results were excellent in 29 cases,good in 26 cases,medium in 8 cases,and poor in 2 cases.The total excellent and good rate was 83.93%.Conclusion:According to the Sanders classification for calcaneal fractures,bone graft or internal fixation treatment is suitable for above SandersⅢ,simple bone graft or internal fixation treatment is suitable for SandersⅢ,bone grafting and internal fixation treatment is suitable for aboveⅢin particular IV.%目的：探讨比较跟骨骨折临床手术治疗中不同植骨内固定选择的临床效果。方法：选取112例根据Sanders分型方法分为Ⅲ型以上的跟骨骨折患者，47例Ⅲ型患者采用单纯植骨或单纯内固定治疗，65例采用植骨+内固定治疗，其中Ⅲ型20例，IV型45例。结果：112例均获随访，时间6~8个月。全部骨性愈合，愈合时间14~22周，跟踝关节功能恢复良好。单纯植骨或单纯内固定组：优24例、良15例、中6例、差2例；植骨+内固定组：优29例、良26例、中8例、差2例；总优良率83.93%。结论：根据跟骨骨折Sanders分型，Ⅲ型以上骨折均需植骨或内固定治疗，单纯植骨或单纯内固定治疗适合部分Ⅲ型骨折，植骨+内固定治疗适合Ⅲ型以上骨折尤其是IV型骨折。