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目的 评价切开复位及使用跟骨解剖型钢板内固定治疗跟骨关节内骨折的可行性及效果.方法 对28例跟骨骨折(其中sanders分型[1]Ⅲ型20例和Ⅳ8例)均采用外侧L型切口跟骨解剖型钢板内固定术.结果 所有患者术后随访6个月～2年,26例基本恢复跟骨高度、长度、宽度;2例患者术后出现明显距下关节炎,行二期距下关节融合术.根据美国足踝外科协会跟骨骨折的评分标准:优6例、良15例、可5例、差2例,优良率达75%.结论 跟骨解剖型钢板内固定治疗sandersⅢ型和Ⅳ型跟骨关节内骨折,可以恢复跟骨的基本形态,得到较好的治疗效果.

Objective To evaluate of open reduction and the use of calcaneal anatomic plate fixation for intraarticular fractures calcaneal of the feasibility and effectiveness.Methods 28 cases of calcaneal fractures(including sanders classification of 20 cases of type Ⅲ and Ⅳ 8 cases)were L-shaped incision with lateral calcaneal anatomic plate fixation.Results All patients were followed up 6 months to 2 years,26 cases regained heel height,length,width; 2 patients after apparent subtalar arthritis,line 2 subtalar arthrodesis.According to the United States Association of Foot and Ankle Surgery calcaneal fracture score criteria:excellent in 6 cases,good in 15 cases,fair in 5 cases and poor in 2 cases,good rate of 75%.Conclusion Calcaneal anatomic plate fixation for type sanders Ⅲ and type Ⅳintraarticular fractures calcaneal,can restore the basic form of heel,get a better therapeutic effect.