Robinson Jon F, Murphy G Andrew
Bridger Orthopedic and Sports Medicine, 931 Highland Boulevard, Suite 3210, Bozeman, MT 59715, USA.
Foot Ankle Clin. 2002 Mar;7(1):107-20. doi: 10.1016/s1083-7515(02)00024-4.
Even with greater emphasis on anatomic reduction, outcomes after calcaneal fractures continue to be unsatisfactory in many patients. Lateral wall impingement, subtalar arthrosis with pain and stiffness, nerve compression syndromes, and hindfoot malalignment all can cause disabling symptoms. If conservative treatment fails to relieve symptoms, subtalar arthrodesis can provide a painless, stable hindfoot in most patients. For severe deformity with anterior ankle impingement and loss of the talar angle of declination, distraction bone block arthrodesis through a posterior approach is preferred.
即使更加强调解剖复位，许多跟骨骨折患者的治疗结果仍不尽人意。外侧壁撞击、距下关节疼痛和僵硬、神经压迫综合征以及后足畸形都可能导致致残症状。如果保守治疗无法缓解症状，距下关节融合术可使大多数患者获得无痛、稳定的后足。对于伴有前踝撞击和距骨倾斜角丧失的严重畸形，采用后入路的撑开植骨融合术更为可取。
