Melcher G, Bereiter H, Leutenegger A, Rüedi T
Department of Surgery, Rätisches Kantons- und Regional-spital, Chur, Switzerland.
J Trauma. 1991 Feb;31(2):234-8.
Since 1980 our treatment of displaced intra-articular calcaneal fractures consists of open reduction with distractor, bone grafting, and internal fixation. Thereby no splints are applied and early postoperative movement is possible. For precise preoperative planning a CT scan is required. Proper timing and careful preoperative planning are essential to prevent soft-tissue complications. In a total of 16 fractures good clinical and radiologic results were achieved in 50% of the cases; results were satisfactory in 25% and poor in 25%. The patients returned to work after an average of 5 months. Only three patients (19%) received disability compensations, which compares favorably with nonoperative treatment. We believe that a majority of comminuted intra-articular fractures of the calcaneus profit from open reduction and internal fixation and that more reliable functional results are achieved than with conservative therapy.
自1980年以来，我们对移位的关节内跟骨骨折的治疗方法包括使用撑开器进行切开复位、植骨和内固定。因此无需使用夹板，术后早期即可活动。为了进行精确的术前规划，需要进行CT扫描。恰当的时机和仔细的术前规划对于预防软组织并发症至关重要。在总共16例骨折中，50%的病例获得了良好的临床和影像学结果；25%的结果令人满意，25%的结果较差。患者平均在5个月后恢复工作。只有3名患者（19%）获得了残疾补偿，这比非手术治疗的情况要好。我们认为，大多数跟骨关节内粉碎性骨折通过切开复位和内固定可从中获益，并且与保守治疗相比，能获得更可靠的功能结果。
