| Objective:Fractures of calcaneus are the most common tarsal bone fractures,account for 60%ofTarsal bone fractures,account for 2%of all fractures,and intral-articular calcaneal fractures account for about 75%of theirselves.Calcaneus takes the body weight through its posterior articular facit.Subtalat joint incongruity and displace would induce its disability of Joint force and action when Subtalat facit is damaged,and it will form traumatic arthritis,and it will affect the activity of foot,outline of foot,difficulty of taking shoes,pain of walking. Lately,Linical and biomechanical study is said that subtalat joint incongruity is very important,and is reletant to linical effect.Slight joint incongruity with CT will induce persistent joint pain and traumatic arthritis.Gavlik et al said that reasons of bad complaint.So restruction of joint congruity is very important in treat of fractures.Subtalar joint calcaneus fractures are treated with open reduction and anatomical reduction.Anatomical characteristics of calcaneus:calcaneus is composed of 3 groupstrabecular bones,And their line intersections are sustentaculum tali,anterior part ofcalcaneus and calcaneus node,andtheir sclerotin is close.The three parts form stereo tribrach.Calcaneus fracture destroys its stable struction,soReset of broken struction must be used total fixation of fracture blocks.There are many classification,and Sanders classification is base on CTof subtalar joint in coronal view and axial view.Patients of Sanders typeⅡ,ⅢandⅣare treated with open reduction and calcaneus plant fixation.Methods:Before operation we measured the Bohler angle and Gissane angle in lateral projection of calcaneus,if the number of Bohler angle is less than 15°or number of Gissane angle is less than 90°or more than 130°,we would use CT of calcaneus evaluate the level of calcaneus fractures and make Sanders classication.20 sides were accounted for typeⅡ,42 for typeⅢ,18 for typeⅣ.we measured the numbers of Bohler angle and Gissane angle after operation in lateral projection.On epidural anesthesia,patients were on supine position or prone position.The skin incision is L-shaped over the lateral aspect of the heel,and then exposed the fractures and calcaneocuboid joint and subtalar joint.After having a good view into the subtalar,we start with reduction of joint.After recovering of calcaneus construction,we fixed the plate with srews through sustentaculum tali,anterior part of calcaneus and calcaneus node.To set drain pipe after operation.Extremity should be immobilized by plaster.The measurement results were registered and all of data were analyzed by SPSS10.0 statistical software,and level of ais 0.05.Results:All the cases were followed-up for an average of 19.4 months(range,12 to 32months).All fractures are healed,and no was unhealed,malunion.7 sides were used autogenous bone grafting,and 6 sides used others on man,and 5 sides mixing grafting,with no bad response..The clinical results were evaluared according to Ankle-Hindfoot Score.The excellent and good rate of typeⅡwas 95.0%,typeⅢ78.6%and typeⅣ72.2%.The difference between the preoperationand postoperation of angles were significant.Conclusion:Open reduction and calcaneus plate inter fixation is a good methond to treat the displaced intra-articular fracture of calcaneus,especially those of SandersⅢandⅣ.
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