Boack Dan-Henrik, Manegold Sebastian
Klinik für Unfall-, Wiederherstellungschirurgie & Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité--Universitätsmedizin Berlin, 13353 Berlin (Campus Virchow-Klinikum), Germany.
Injury. 2004 Sep;35 Suppl 2:SB23-35. doi: 10.1016/j.injury.2004.07.019.
Peripheral fractures of the talus are uncommon and often overlooked. CT scanning has become the imaging modality of choice and is necessary for decision making on treatment. Displaced peripheral fractures have to be managed with open reduction and internal fixation. Precise anatomical reduction is necessary to achieve a good result. A rigid internal fixation with interfragmentary lag screws is the method of choice in almost all fractures, which allows early postoperative mobilization. The outcome is related to the degree of the chondral lesion and the degree of instability of the subtalar joint, but it may be poor due to the treatment. Early diagnosis and proper treatment achieve the best possible results and prevent long-term complications. Typical complications of the fracture are nonunion and malalignment with slight subtalar instability or osseous overgrowth with secondary impingement and posttraumatic subtalar arthritis.
距骨周围骨折并不常见，且常被忽视。CT扫描已成为首选的影像学检查方式，对于治疗决策至关重要。移位的距骨周围骨折必须通过切开复位内固定进行处理。精确的解剖复位对于取得良好疗效很有必要。几乎所有骨折首选使用骨折块间拉力螺钉进行坚强内固定，这允许术后早期活动。预后与软骨损伤程度和距下关节不稳定程度有关，但治疗可能导致预后不佳。早期诊断和恰当治疗可取得最佳效果并预防长期并发症。骨折的典型并发症包括不愈合、伴有轻微距下关节不稳定的畸形愈合或伴有继发性撞击和创伤后距下关节炎的骨质过度生长。
