背景：目前对 SandersⅢ型、Ⅳ型骨折手术治疗恢复破坏的跟骨距下关节面和跟骨形态，以减少创伤性关节炎的发生已达成共识，而对于跟骨骨折术中是否植骨一直是个有争议性的问题。目的：观察Genex人工合成骨填充材料及锁定钢板治疗粉碎性跟骨骨折的临床疗效。方法：回顾性分析21例SandersⅢ型、Ⅳ型跟骨骨折患者的临床资料，其中男16例，女5例，年龄22-55岁，采用外侧“L”形入路，跟骨骨折复位后将调好成面团样的 Genex 人工骨粉填塞缺损区，再将外侧壁骨块复位，将预弯好的锁定钢板置入。随访观察骨折愈合情况、Bolher角及Maryland足部评分。结果与结论：21例患者均获随访，随访时间8-16个月，骨折均愈合，无移位、塌陷及排斥反应，人工骨粉约6个月被降解，1年后完全被吸收，并为新骨所取代；按Maryland足部评分优良率达86%，Bolher角从治疗前的(5.30±3.35)°恢复至末次随访后的(24.30±1.06)°。结果表明 Genex 人工骨粉是一种完全吸收、可塑性好、支撑力强的生物材料，能够充分填充骨缺损，便于骨折复位、诱导成骨、促进骨折愈合。%BACKGROUND:Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue. OBJECTIVE:To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures. METHODS:Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral“L”shaped approach, and then the lateral wal of the bone was reset fol owed by internal fixation with the pre-curved locking plate. Fol ow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score. RESULTS AND CONCLUSION:Total y 21 patients were fol owed up for 8-16 months. The fractures were healed without displacement, col apse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to ful y fil bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.
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