以 Essex-Lopresti 法治療跟骨骨折

Treatment of Calcaneal Fractures with Essex-Lopresti Method

李建和(China-Her Lee) ； 蔣漢民(Han-Min Chiang) ； 邵克勇(Keh-Young Shaw)

《Journal of Orthopaedic Surgery Taiwan》 4卷3期 (1987/09) Pp. 103-108

摘要

三軍總醫院從民國71年至73年中有37位患者併有45個跟骨骨折，平均年齡為28.5歲，2/3為男性。大部份患者受傷機轉為高處跌落，足跟著地所引起，約有23.6%的患者合併有胸腰椎的骨折○。跟骨骨折可分為關節外骨折及關節內骨折兩大類。關節外骨折可分為前突、內突、粗隆、體部及距支柱 ( Sustentaculum tali ) 的骨折。關節內骨折則包括未移位型要舌狀型、關節凹陷型及粉碎型骨折等。本院患者以舌狀型占33%及關節凹陷型占31%為最常見。14位舌狀型及9位關節凹陷型患者以Essex-Lopresti法治療，即是以閉鎖性復位術併經皮穿刺鋼釘內固定及石膏固定來治療。平均追蹤治療為期2年8個月。其結果為78.5%舌狀型骨折得到良好的結果而僅有44%關節凹陷型骨折得到良好結果。手術後鮑氏角 ( Bohler's Angle ) 之矯正度數在10度以上者有較好的結果，跟骨後關節面有對稱性復位者預後較佳。

關鍵字

跟骨骨折舌狀型 ； 關節凹陷型 ； Essex-Lopresti法 ； 鮑氏角

並列摘要

This retrospective study was designed to assess the effect of the Essex-Lopresti method in the treatment of calcaneal fractures.
There were 37 patients with 45 fractures of the calcaneum treated at the Tri-Service general Hospital from 1982 to 1984. The fractures were divided into extra-articular fractures (16%), and intraarticular fractures (84%) which included nondisplaced (4%), tongue type (33%), joint depression type (31%), and comminuted fractures (15%). About 23.6% of patients had associated fractures of the thoracolumbar spine.
Fourteen tongue type and 9 joint depression type fractures were treated with Essex-Lopresti method. The treatment produced 78.5% good result in tongue type fractures but only 44% in joint depression type fractures. The reduction of the posterior facet joint is the essential prognostic factor.
As found by previous studies, the Essex-Lopresti method was a favorable method for tongue type fractures. However, the joint depression type fractures were best treated by open reduction and autogenous bone graft.

並列關鍵字

Tongue type ； Joint depression ； Essex-Lopresti ； Bohler's Angle