Schwall R, Junge R H, Zenker W, Besch L
Klinik für Unfallchirurgie (Traumatologie), Christian-Albrechts-Universität Kiel.
Unfallchirurg. 2000 Dec;103(12):1065-72. doi: 10.1007/s001130050670.
Operative treatment of the calcaneus is still in discussion. For a better management of soft tissue problems an optimized fixator frame for primary treatment of calcaneus fractures was developed in the Dept. of trauma surgery University of Kiel. A one-plane bilateral construction with one insertion point in the tibia and two in the tuberosity of calcaneus is used. It allows efficient reduction by ligamentotaxis, stable fixation and active motion in ankle joint. We treated 40 patients with 45 calcaneus fractures. In 25 cases the fixator was definite and later plate or screw fixation was performed 20 times. 35 patients with 40 fractures were examined by means of the "Kiel score for calcaneus fractures". Patients who were treated definite reached better longterm-results on average than patients who underwent a secondary open osteosynthesis. Concrete guidelines for the therapy of intraarticular calcaneus fractures are presented.
跟骨的手术治疗仍存在争议。为了更好地处理软组织问题，基尔大学创伤外科研发了一种用于跟骨骨折一期治疗的优化固定架。采用单平面双侧结构，在胫骨有一个插入点，在跟骨结节有两个插入点。它允许通过韧带整复进行有效复位、稳定固定以及踝关节的主动活动。我们治疗了40例患者的45处跟骨骨折。25例患者使用固定架确定有效，之后进行钢板或螺钉固定20次。采用“基尔跟骨骨折评分”对35例患者的40处骨折进行了检查。接受确定性治疗的患者平均而言长期效果优于接受二期切开复位内固定的患者。文中给出了关节内跟骨骨折治疗的具体指南。
