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目的 探讨微创经皮钢板固定(minimally invasive percutaneous plate osteosynthesis,MIPPO)技术治疗跟骨骨折的临床疗效.方法 回顾性分析 2010 年 1 月至 2015 年 9 月在我院采用 MIPPO 技术治疗的跟骨关节内骨折 31 例(共 35 足 ),骨折分型为 Sanders II 型(16 例 )、III 型(15 例 ).手术切口采用跟骨外出跗骨窦切口结合跟腱前缘直行小切口,骨折固定采用跟骨外侧解剖板.采用 Maryland 足部评分系统及影像学检查进行评价.结果 本组均获得随访,随访时间 12~24 个月,平均 15.2 个月.本组骨折均愈合,未出现骨折延迟愈合及不愈合病例,也无切口感染及切口不愈合等并发症发生.患者完全下地负重时间 3~4 个月,平均3.5 个月.跟骨 Bohler 角术前平均为(8.2±5.5)°,术后平均为(28.5±4.3)°,术前、术后 Bohler 角对比,差异有统计学意义(P<0.05 ).跟骨 Gissane 角由术前平均(96.5±9.5)° 恢复至末次随访时(120.4±6.3)°,差异有统计学意义(P<0.05 ).本组术后与末次随访相比,跟骨 Bohler 角、Gissane 角均无明显丢失.Maryland 足部评分:优 18 足,良 13 足,可 4 足,优良率为 88.5%.其中 Sanders II 型骨折优 10 足,良 6 足,可 1 足,优良率为 94.1%;Sanders III 型骨折优 9 足,良 7 足,可 2 足,优良率 88.9%.结论 采用 MIPPO 技术治疗 Sanders II、III 型骨折均能获得满意疗效且避免并发症发生,Sanders II 较 Sanders III 患者足部评分更高.“,”Objective To evaluate clinical effects of minimally invasive percutaneous plate osteosynthesis ( MIPPO ) in the treatment of calcaneal fractures. Methods From January 2010 to September 2015, 31 cases ( 35 feet, intra-articular calcaneal fractures ) treated with MIPPO were retrospectively analyzed. Fracture classification: Sanders II ( 16 cases ), Sanders III ( 15 cases ). Surgical incision: calcaneal tarsal sinus incision with a small straight edge incision of the Achilles tendon. Fracture was fixed by calcaneal lateral dissection plate. The results were evaluated by Maryland foot scoring system and radiographic examination. Results All patients were followed up for 12 - 24 months ( average:15.2 months ). All fractures healed. No delayed union or nonunion occurred. There were no complications such as wound infection and incision nonunion. Complete load-bearing time ranged 3 - 4 months ( average: 3.5 months ). The average Bohler angle was ( 8.2 ± 5.5 ) ° preoperatively and ( 28.5 ± 4.3 ) ° postoperatively with statistical difference ( P < 0.05 ). The Gissane angle of the calcaneus recovered from ( 96.5 ± 9.5 ) ° preoperatively to ( 120.4 ± 6.3 ) ° at the final follow-up, and the differences were statistically significant ( P < 0.05 ). All patients had no significant loss of calcaneus Bohler angle or Gissane angle compared with those at the final follow-up. Maryland Foot score:excellent 18 feet, good 13 feet, fair 4 feet, excellent and good rate 88.5%. Sanders II: excellent 10 feet, good 6 feet, fair 1 foot, excellent and good rate 94.1%. Sanders III: excellent 9 feet, good 7 feet, fair 2 feet, excellent and good rate 88.9%. Conclusions MIPPO can achieve good clinical results in the treatment of Sanders II and III fractures, while Sanders II results are more satisfactory than Sanders III.