Department of Surgery, Traumatology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, Room H822-k, 3000 CA, Rotterdam, The Netherlands.
Arch Orthop Trauma Surg. 2009 Dec;129(12):1677-83. doi: 10.1007/s00402-009-0915-8. Epub 2009 Jun 19.
A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the different percutaneous distractional approaches for intra-articular calcaneal fractures. The history, technique, anatomical and fracture considerations, limitations and the results of different distractional approaches reported in the literature are reviewed.
Literature review on different percutaneous distractional approaches for displaced intra-articular calcaneal fractures.
Eight studies in which application of a distraction technique was used for the treatment of calcaneal fractures were identified. Because of the use of different classification, techniques, and outcome scoring systems, a meta-analysis was not possible. A literature review reveals overall fair to poor result in 10-29% of patients. Ten up to 26% of patients are unable to return to work after percutaneous treatment of their fracture. A secondary arthrodesis has to be performed in 2-15% of the cases. Infectious complications occur in 2-15%. Some loss of reduction is reported in 4-67%.
Percutaneous distractional reduction and fixation appears to be a safe technique with overall good results and an acceptable complication rate, compared with other treatment modalities for displaced intra-articular calcaneal fractures. A meta-analysis, based on Cochrane Library criteria is not possible, because of a lack of level 1 and 2 trials on this subject.
在文献中已经描述了多种治疗跟骨骨折的方法。没有一种单一的治疗方法对移位的关节内跟骨骨折是优越的。这篇综述描述并比较了不同的经皮牵张入路治疗关节内跟骨骨折。回顾了文献中报道的不同牵张入路的历史、技术、解剖和骨折注意事项、局限性以及结果。
对经皮牵张治疗移位的关节内跟骨骨折的不同方法进行文献回顾。
确定了 8 项应用牵张技术治疗跟骨骨折的研究。由于使用了不同的分类、技术和结果评分系统，因此无法进行荟萃分析。文献回顾显示，总体上有 10-29%的患者的结果是良好至较差。10-26%的患者在经皮治疗骨折后无法重返工作岗位。2-15%的病例需要进行二次融合。2-15%的病例发生感染并发症。4-67%的病例报告有一定程度的复位丢失。
与其他治疗移位的关节内跟骨骨折的方法相比，经皮牵张复位和固定似乎是一种安全的技术，具有总体良好的结果和可接受的并发症发生率。由于缺乏针对这一主题的 1 级和 2 级试验，根据 Cochrane 图书馆的标准进行荟萃分析是不可能的。
