Kirschner Wire Poking Reset And Titanium Alloy Plate Fixation For The Treatment Of Intra-articular Calcaneal Fractures

Objective Through the summary and analysis of Kirschner wire poking reset and titanium alloy plate fixation for the treatment of intra-articular calcaneal fractures results of clinical data and follow-up to explore the Kirschner wire poking reset and titanium alloy plate fixation for the treatment of intra-articular calcaneal fractures clinical efficacy and complications,sum up experience and lessons for clinical use of Kirschner wire poking reset and titanium alloy plate fixation for the treatment of intra-articular calcaneal fractures provide the basis.Methods From February 2004～April 2008 in Wuhan eleventh hospital treated 45 cases of a total of 55 lateral calcaneal fractures in 28 cases of male,female 17 cases.One of 10 cases were bilateral, 13 cases of combined fractures,age 20～62 years old.Injury causes: 36 cases of falling injuries,nine cases of car accident injuries. Preoperative lateral calcaneal are taken,adequate axial and oblique X-ray film,parallel three-dimensional reconstruction of CT examination,in accordance with the sanders CT Category:Ⅱ-type 26 feet,Ⅲ-type 15 feet,Ⅳ-type 14 feet,are affected with the distance articular surface.1 week after injury,surgery 31 cases (39 feet),1 week to 2 weeks after surgery in 14 cases((16 feet). Kirschner poking reset line and titanium alloy plate fixation,some suffering from foot artificial bone implants compartmentalization support treatment,all patients with functional exercise with the guidance of the late Chinese medicine decoction Fumigation.Results Section 55 of the 45 cases of adequate follow-up time of 6～26 months,an average of 18.3 months.By the Maryland foot score system for evaluation,full functional recovery after a good, good rate of 83.6%.Imaging examination,preoperative Bohler's angle(normally 25°～40°) an average of 14.57°,after fixation at the time of check Bohler' s angle average of 24.81°; preoperative Gissan' s angle(normally 120°～145°) an average of 161.42°,after fixation at the time of check Gissan' s angle average 138.12°;preoperative Perie' s angle(normally 15°～17°) an average of 27.82°,after fixation at the time of check Perie' s angle average of 17.38°,preoperative and postoperative two have significant differences.Postoperative complications: superficial infection incision 4 feet(7.3%),deep infection 0 feet (0.0%);sural nerve injury 0 feet(0.0%);peroneal tendinitis 2 feet (3.6%);traumatic joint Yan 8 feet(14.6%).Conclution Kirschner wire poking reset and titanium alloy plate fixation for the treatment of intra-articular calcaneal fractures, as long as the master principle of treatment,surgical indications and surgical timing,attention to non-invasive surgery techniques, refresher facial subtalar joint anatomical relations,the restoration of Bohler angle,Gissane calcaneal angle and body length,width and height;attention to postoperative drainage,the application of antibiotics,wound care,early functional exercise with the Chinese Washing can reduce complications,and achieved satisfactory results.