The CT Measurement Study And Operation Mode Study Of Intra-articular Fractures Of Calcaneus

Objective:To approach CT measurements of the calcaneus and the guiding role to the therapy of intra-articular calcaneal fractures.From the study Of the surgical treatment of different types of intra-articular calcaneal fractures,with a view to find the optimal treatment.Methods:Screening of Shandong University of Traditional Chinese Medicine Hospital orthopedic from the intra-articular calcaneal fractures of 71 cases with 71 feet from June 2005 to November 2007,in all X-ray,Multi-slice Spiral(MS) CT scanning and muhiplanar reconstruction(MPR),according to Sanders type,SandersⅡcases in this group of 32 cases,24 cases of SandersⅢ,SandersⅣof 15 cases.1.Compare the difference of fracture lines,fragment translocation and joint involvement on X-line,MSCTand MPR; 2.Analysis of the fracture line with the form and follow-law on MSCT and MPR;3.survey calcaneum forehead width,middle width,calcaneum length and peries corner on MSCT healthy side and catch side numerical value;4.Analyze the therapeutic effectiveness of eacd Sanders type'Maryland foot function grade adopting different operative treatment. Results:1.This group singlet fracture nine cases,multiline fracture sixty-two cases, fragment translocation forty-six cases,joint involvement seventy,one cases,MSCT and MPR's picking up rate equals for 100%,X-line's picking up rates separate for 66.7%,74.2%,60.9%,45.1%;2.The fracture line shape presents for five genera of the intra-articular calcaneal fractures:(1) diagonal shape nine cases;(2) "Y" shape twelve cases;(3)pour "Y" shape eleven cases;(4) irregularity shape five cases;(5) cave or translocation shape thirty-nine cases;3.The Calcaneum forehead width,middle width, length,peries angulus of catch side compared with healthy side average transfer respectively 10.85mm,9.03mm,5.50mm,14.58°,P barring Calcaneum length is greater than 0.05,having not statistics sense,rest equally are less than 0.01,possessing obvious tatistics sence,thereinto,Calcaneum forehead width catch side compared healthy side broaden particularly for distinctness.4.SandersⅡtype,Ⅲtype:open reduction internal fixation is better than poking reposition;Ⅳtype:treatment of open reduction internal fixation,poking reposition and joint fusion do not possess statistics sense.5.Treatment effect of open reduction intemal fixation,sandersⅡtype is better thanⅣtype;Ⅲtype andⅣtype have not statistics sence.Conclusion:1.Distance of intra-articular calcaneal fractures of MSCT and MPR is better than X-ray inspection;2.CT measurement can accurately reflect the articular surface of the translocation and shape transfer;3.Type SandersⅡ,Ⅲcalcaneal fractures appropriate to use openning reduction and internal fixation,Ⅳtype appropriate to joint confluens,its treatment is multiplicity,we should select appropriate treatment.