Squires B, Allen P E, Livingstone J, Atkins R M
Bristol Royal Infirmary, England, UK.
J Bone Joint Surg Br. 2001 Jan;83(1):55-61. doi: 10.1302/0301-620x.83b1.11184.
We describe 24 fractures of the tuberosity of the calcaneus in 22 patients. Three were similar to the type of avulsion fracture which has been well-defined but the remainder represent a group which has been unrecognised previously. Using CT and operative findings we have defined the different patterns of fracture of the calcaneal tuberosity. Ten fractures extended into the subtalar joint, but did not fit the pattern of the common intra-articular fracture as described classically. We have defined a new pattern which consists of a fracture of the medial calcaneal process with a further fracture which separates the upper part of the tuberosity in the semicoronal plane. Non-operative treatment of displaced fractures resulted in a mis-shapen heel and a poor functional outcome. Open reduction and internal fixation with either a plate or compression screw did not give satisfactory fixation. We prefer to use an oblique lateral tension-band wire. This technique gave excellent fixation and we recommend it for the treatment of displaced fractures of the tuberosity of the calcaneus.
我们描述了22例患者的24例跟骨结节骨折。其中3例类似于已明确界定的撕脱性骨折类型，但其余的代表了一个以前未被认识的骨折组。通过CT和手术结果，我们确定了跟骨结节骨折的不同模式。10例骨折延伸至距下关节，但不符合经典描述的常见关节内骨折模式。我们定义了一种新模式，包括跟骨内侧突骨折以及在半冠状面将结节上部隔开的另一处骨折。移位骨折的非手术治疗导致足跟畸形且功能预后较差。使用钢板或加压螺钉进行切开复位内固定并不能获得满意的固定效果。我们更倾向于使用斜外侧张力带钢丝。该技术提供了出色的固定效果，我们推荐将其用于治疗跟骨结节移位骨折。
