Gustilo Ⅲ型及Sanders Ⅳ型跟骨骨折的治疗_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 聂涛 , 戴闽 , 邹帆 , 李明军 , 刘俊

南昌大学第一附属医院骨科（南昌，330006）;

Corresponding author：

聂涛, Email: ncnietao@163.com

Keywords：

跟骨骨折; 开放性骨折; 穿支皮瓣; 内固定

DOI：

10.7507/1002-1892.20150169

Video：

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目的总结手术治疗GustiloⅢ型及Sanders Ⅳ型跟骨骨折的疗效。方法 2011年5月－2014年6月，收治9例GustiloⅢ型及Sanders Ⅳ型跟骨骨折患者。男7例，女2例；年龄21～56岁，平均37.6岁。致伤原因：高处坠落伤7例，交通事故伤2例。左侧6例，右侧3例。伤后至入院时间2～18 h，平均7.2 h。一期行彻底清创、封闭式负压引流（vacuum sealing drainage,VSD）治疗，二期行跟骨骨折复位内固定、小腿内侧胫后动脉穿支皮瓣修复创面。结果术后2例跟骨内侧创面发生浅表感染、1例跟骨外侧切口愈合不良；其他患者切口均Ⅰ期愈合，皮瓣均顺利成活。患者均获随访，随访时间7～26个月，平均12.8个月。X线片复查示骨折均愈合。末次随访时，根据美国矫形足踝协会（AOFAS）踝与后足评分标准为78～88分，平均81.3分。结论一期彻底清创、VSD治疗，二期行跟骨内固定及胫后动脉穿支皮瓣移位修复是治疗GustiloⅢ型及Sanders Ⅳ型跟骨骨折的一种有效方法。

Citation： 聂涛, 戴闽, 邹帆, 李明军, 刘俊. Gustilo Ⅲ型及Sanders Ⅳ型跟骨骨折的治疗. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 787-788. doi: 10.7507/1002-1892.20150169 Copy

1.	Benirschke SK, Kramer PA. Wound healing complications in closed and open calcaneus fractures. J Orthop Trauma, 2004, 18(1):1-6.
2.	Heier KA, Infante AF, Walling AK, et al. Open fractures of the calcaneus:soft-tissue injury determines outcome. J Bone Joint Surg (Am), 2003, 85-A(12):2276-2282.
3.	Beltran MJ, Collinge CA. Outcomes of high-grade open calcaneus fractures managed with open reduction via the medial wound and percutaneous screw fixation. J Orthop Trauma, 2012, 26(11):662-670.
4.	Aldridge JM 3rd, Easley M, Nunley JA. Open calcaneal fractures:results of operative treatment. J Orthop Trauma, 2004, 18(1):7-11.
5.	Thomton SJ, Cheleuitte D, Ptaszek AJ, et al. Treatment of open intra-articular calcaneal fractures:evaluation of a treatment protocol based on wound location and size. Foot Ankle Int, 2006, 27(5):317-323.
6.	Lawrence SJ, Grau GF. Evaluation and treatment of open calcaneal fractures:a retrospective analysis. Orthopedics, 2003, 26(6):621-626.

1. Benirschke SK, Kramer PA. Wound healing complications in closed and open calcaneus fractures. J Orthop Trauma, 2004, 18(1):1-6.
2. Heier KA, Infante AF, Walling AK, et al. Open fractures of the calcaneus:soft-tissue injury determines outcome. J Bone Joint Surg (Am), 2003, 85-A(12):2276-2282.
3. Beltran MJ, Collinge CA. Outcomes of high-grade open calcaneus fractures managed with open reduction via the medial wound and percutaneous screw fixation. J Orthop Trauma, 2012, 26(11):662-670.
4. Aldridge JM 3rd, Easley M, Nunley JA. Open calcaneal fractures:results of operative treatment. J Orthop Trauma, 2004, 18(1):7-11.
5. Thomton SJ, Cheleuitte D, Ptaszek AJ, et al. Treatment of open intra-articular calcaneal fractures:evaluation of a treatment protocol based on wound location and size. Foot Ankle Int, 2006, 27(5):317-323.
6. Lawrence SJ, Grau GF. Evaluation and treatment of open calcaneal fractures:a retrospective analysis. Orthopedics, 2003, 26(6):621-626.

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Chinese Journal of Reparative and Reconstructive Surgery

Gustilo Ⅲ型及Sanders Ⅳ型跟骨骨折的治疗

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