探讨跟骨关节内骨折的手术治疗效果 姜中立.docVIP

精品论文 参考文献 探讨跟骨关节内骨折的手术治疗效果 姜中立 北安市第三人民医院 164000 　　摘要：目的 研究并分析手术治疗跟骨关节内骨折的临床疗效并防治并发症。方法 此次研究的对象是选取本院2010年6月～2011年12月收治的40例跟骨关节内骨折的患者（共45足），将其临床资料进行回顾性分析，并采用改良的外侧入路切开复位钢板内固定手术治疗，观察分析骨折愈合情况及并发症的发生情况。结果 随访8～24个月，平均随访时间为16个月。骨折全部愈合，无内固定松动及再骨折发生。按Maryland足部评分标准对手术效果进行评价，其中，优29足，评分在90～100分；良10足，评分在75～89分；可4足，评分在50～74分；差2足，评分lt;50分，优良率为86.7%。结论 关节的复位和牢固的固定是跟骨关节内骨折的手术治疗的关键。对于Sanders Ⅱ～Ⅳ型的跟骨关节内骨折，疗效方面理想，尤其对于跟距关节面的骨折以及移位明显的跟骨关节内骨折疗效更为可靠，实施手术治疗是必要的，临床上值得推广使用。另外重视对距下关节面的复位及重建距下关节面的完整性，可以有效地避免并发症。 　　关键词：手术治疗；跟骨关节内骨折；临床疗效；观察 　　[Abstract] Objective To study and analyze the clinical effect of surgical treatment of intra-articular calcaneal fractures and to prevent and cure the complications.The object of this research method is selected in the hospital from June 2010 to December 2011 were 40 cases of intraarticular calcaneal fracture patients (45 feet)，the retrospective analysis of the clinical data，and using a modified lateral approach for open reduction and internal fixation surgery，observation and analysis of fracture healing and complications.Results all the patients were followed up for 24 to 8 months.The mean follow-up period was 16 months.All fractures were healed，no internal fixation loosening and re fracture occurred.According to the Maryland standard for evaluation of surgical foot evaluation，the score was excellent in 29 feet，90 ~ 100；10 good，the score in 75 ~ 89；4 feet，the score in 50 to 74 points；2 feet，lt;50 scores，the excellent rate was 86.7%.Conclusion the reduction and fixation of the joint is the key to the surgical treatment of intra-articular calcaneal fracture.For the Sanders II ~ type IV calcaneal fracture curative effect ideal，especially for the talocalcaneal articular surface fractures and displaced intra-articular fractures of the calcaneus obvious curative effect is more reliable，surgical treatment is necessary，it is worth popularizing in the clinic.In addition to attention from the reduction and reconstruction of the articular surface of the subtalar jo