【作者】 郑韶博； 赵立强； 刘伟； 李景先；

【Author】 Zheng Shao-bo Zhao Li-qiang Liu Wei. Deptament of orthopaedic,The fifth Hospital in Harbin

【机构】 哈尔滨市第五医院骨科；

【摘要】 目的:通过对跟骨关节内骨折的病理解剖学深入地研究,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,并根据 CT 分型应用自行设计的近"山"字型跟骨钢板进行手术治疗, 术后不用任何形式的外固定,并早期功能练习。结果:平均愈合时间为8周,术后平均18个月, 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此近"山"字型跟骨钢板解决了跟骨骨折难固定难题,能对跟骨骨折起到坚强的固定怍用,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 intmai fixation of the intra-articular fracture of calcaneus through substantially study on it’s pathologic anatomy.Method:26 cases of intra-articular fracture of calcaneus were scanned by CT,and CT typing was prodused depanding on the pathologic change during the operating.The steel plate,which designed by ourselves,was applied according to different CT typing.Nothing is necessary to exetmal fix but it is permitted to early exercise.Resul:The union time averaged 8 weeks,and the steels plates were get out on averaged 8 months.The follow-up period averaged 18 months and the ratio of excellent and good results was90.32%.Conclusion:①The CT typing is help to judge the collapsed extent of the post calcaneus articular surface and especially contribute to decide wether using bone grafting or applying arthroscopy to monitate the post articular surface②The plates solve successly 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