Objective To analyze the effect of open reduction and internal fixation (ORIF) with unlocking plate or locking plate for treatment of adult intra-articular calcaneal fracture. Methods 68 cases of calcaneal fracture,including 72 feet in 56 males (4 males were bilateral) and 12 females,with the average age of 35 years (ranging from 18 to 71), were en-rolled. According to Sanders' classification,15 feet were classified as type Ⅱ,46 feet were classified as type Ⅲ, and 11 feet were classified as type Ⅳ. 44 feet were treated with unlocking plate for calcaneal fracture in group A , 28 feet were treated with locking plate for calcaneal fracture in group B. The cases of existing ipsilateral lower limb fracture, ipsilateral vascular injury, and ipsilateral lower limb open injury were excluded. Results The wounds of 64 feet healed piemarily,5 feet were delayed healing. The soft tissue coloboma of 3 feet delayed until pedicle flap transfered. The B(o)hler angle of two groups were significantly different between preoperation and postoperation, but there were no significant differences in B(o)hler angle between two groups. 64 feet in 63 cases were followed up for 12~26 months. According to the AOFAS Ankle-Hindfoot Scale ,49 feet scored 90~100 points,13 feet scored 75~89 points and 2 feet scored 50~74 points. The excellent and good rate was 96.9%. Conclusion ORIF with unlocking plate or locking plate are all effective methods to treat the calcaneal fracture , there are no significant dif-ferences in curative effect between the two methods.%目的 分析普通接骨板与锁定接骨板治疗成人闭合性跟骨骨折的临床疗效. 方法 本组跟骨骨折68例(72足),男56例,女12例,4例男性为双侧. 年龄18~71岁,平均35岁. 应用Sanders分型,其中Ⅱ型15足,Ⅲ型46足,Ⅳ型11足.其中应用非锁定跟骨接骨板治疗44足(A组),应用锁定跟骨接骨板治疗28足(B组).排除术前合并同侧下肢骨折、同侧血管损伤及同侧下肢开放性损伤患者. 结果 两组64足切口一期愈合,5足切口不愈合或延迟愈合,给予换药后瘢痕愈合,3足出现皮肤软组织缺损内固定物外露,换药清创后行同侧腓肠神经营养血管筋膜皮瓣转移修复后愈合. 手术前后B(o)hler角两组组内比较差异有统计学意义,两组之间比较差异无统计学意义. 术后63例(64足)获得随访,随访12~26个月,应用AOFAS评分评价,优(90~100分)49足,良(75~89分)13足,一般(50~74分)2足,优良率96.9%. 结论 应用锁定与非锁定接骨板治疗闭合性成人跟骨骨折均能获得良好的治疗效果,两种方法的疗效并无显著性差异.
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