【摘要】 目的通过对跟骨关节内骨折的病理解剖学研究,探讨其CT分型与疗法的改进。方法对26例31侧跟骨关节内骨折的病人进行CT扫描,并结合术中病理改变,提出跟骨骨折CT影像分型方法,根据CT分型应用自行设计的近“山”字形跟骨钢板进行手术治疗,术后不用任何形式的外固定,早期功能练习。结果平均愈合时间为8周,手术优良率为90.32%。结论(1)此CT分型对跟骨后关节面塌陷和粉碎程度的判定有积极意义,对术中是否植骨和是否使用关节镜监控跟骨后关节面的复位质量及预后有重要的判断价值;(2)此钢板对跟骨骨折起到坚强的固定作用,使距下关节早期活动,减少合并症的发生。更多还原

【Abstract】 Objective:To explore the CT typing and internal fixation of the intra articular fracture of calcaneus through substantially study on it’s pathologic anatomy.Method:Twenty six cases of intra articular fracture of calcaneus were scanned by CT,and CT typing was produced depending on the pathologic change during the operation.The steel plate,which designed by ourselves,was applied according to different CT typing.Nothing was necessary for external fixation but it was permitted to start early exercise.Result:The union time averaged 8 weeks,and the steels plates were removed out on averaged 8 months.The follow-up period averaged 18 months and the ratio of excellent and good results was 90.32%.Conclusion:(1)The CT typing is helping to judge the collapsed extent of the post calcaneus articular surface and especially contribute to decide weather using bone grafting or applying arthroscopy to monitate the post articular surface.(2)The plates solve successfully the difficult problem about internal fixation and is strong enough to exercise the subtalar joint early,which can effectively decrease the complication.更多还原