Orthopaedics & Rheumatology, St. Jude Heritage Medical Group, 100 East Valencia Mesa Drive, Suite 105, Fullerton, CA 92835, USA.
Injury. 2009 Feb;40(2):139-45. doi: 10.1016/j.injury.2008.07.016. Epub 2009 Feb 5.
Ipsilateral talar and calcaneal fractures represent a rare combination injury that has only recently been reported in the literature with small case series.
To identify the commonly observed fracture patterns, complications, and outcomes of a consecutive series of patients with ipsilateral talar and calcaneal fractures.
Forty-five cases of ipsilateral talus and calcanal fractures were identified from an orthopaedic trauma registry at a University-based, level I trauma center for retrospective review.
Post-operative complications, the need for secondary surgery, and the visual analogus pain score.
Five patients were treated with an early below knee amputation (BKA). Five patients were treated with a primary subtalar arthrodesis. Twenty-eight of the 35 patients who did not undergo early BKA or primary subtalar arthrodesis developed subtalar arthritis. Five patients had deep wound complications. Four patients had talar body collapse from avascular necrosis. There were 13 open fractures of which 8 resulted in an eventual BKA. The mean visual analogus pain score for the patient population was 4.0.
The combination of ipsilateral talar and calcaneal fractures represents a severe injury pattern that is associated with significant morbidity. Subtalar arthritis was a common finding regardless of treatment. Open fractures frequently resulted in a below knee amputation.
同侧距骨和跟骨骨折是一种罕见的联合损伤，最近才在文献中小样本系列中报道。
确定连续系列同侧距骨和跟骨骨折患者常见的骨折模式、并发症和结果。
从一所大学的一级创伤中心的骨科创伤登记处回顾性确定了 45 例同侧距骨和跟骨骨折的病例。
术后并发症、需要二次手术以及视觉模拟疼痛评分。
5 例患者接受了早期膝下截肢（BKA）。5 例患者接受了初次跗骨关节融合术。在未接受早期 BKA 或初次跗骨关节融合术的 35 例患者中，28 例发生距下关节炎。5 例患者出现深部伤口并发症。4 例患者因股骨头坏死出现距骨体塌陷。有 13 例开放性骨折，其中 8 例最终行 BKA。患者人群的平均视觉模拟疼痛评分（VAS）为 4.0。
同侧距骨和跟骨骨折的组合代表一种严重的损伤模式，与显著的发病率相关。无论治疗方法如何，距下关节炎都是常见的表现。开放性骨折常导致膝下截肢。
