保留距下关节的跟骨截骨术治疗跟骨骨折畸形愈合

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Abstract Objective To discuss results of treating calcaneal fracture malunion by reserving or restoring the subtalar joint with calcaneal osteotomy.Methods From January 2014 to February 2016，20 patients(21 feet) with the mean time from initial injury to reconstructive operation of 3～11(5±2.5)months were treated by oblique osteotomy at the calcaneal body which gained the correction by traslation of calcaneal tuber，and a new the intra-articular osteotomy to restor subtalar joint using excisinal lateral wall grafting.The incisions were closed at one stage in 20 cases，and the flap was used to cover the wound in 1 case.19 feet in 19 patients were follow-up for (11±1.5)months(12～18 months)except for 1 patients losing follow-up after 3 months after operation.The clinical effect were evaluated by clinical outcomes and radiographical result.Results Four(21.1％) of nineteen feet had delayed wound healing with no deep infection.All of patients achieved initial union at 10～12 weeks，in which 6 cases had different degrees of residual pain at the lateral aspect of the ankle.The postoperative Maryland foot score was significantly higher and the B-hler’s angle，Gissane’s angle，talus declination angle，and width and height of calcaneus were improved greatly than the preoperative assessment and the difference was statistically significant.Conclusion Reserving or restoring the subtalar joint with calcaneal osteotomy can regain the calcaneal shape and biomechanical mechanism，and achive good clinical effect in treating calcaneal malunion with normal or most normal articular cartilage in the subtalar joint.

Key words： calcaneal fracture malunion subtalar joint osteotomy

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[1]	. [J]. sygkzz, 2021, 27(2): 183-186.