Sproule James A, Glazebrook Mark A, Younger Alastair S
Department of Orthopaedic Surgery, QEII Health Sciences Centre, Halifax Infirmary, 1796 Summer Street, Halifax NS, B3H 3A7, Canada.
Foot Ankle Clin. 2012 Mar;17(1):117-25. doi: 10.1016/j.fcl.2011.11.009. Epub 2011 Dec 22.
Posttraumatic malalignment after talar neck fractures invariably leads to painful functional impairment. Anatomic reduction and definitive, stable osteosynthesis at the primary surgical intervention is preventative. Secondary anatomic reconstruction with joint preservation should be considered in the absence of arthrosis in the peritalar articulations. Reorientating arthrodeses should be entertained where deformity has resulted in joint incongruity and, ultimately, posttraumatic arthritis. TAA may have a role as a motion-conserving procedure in combination with adjacent subtalar and midtarsal fusions.
距骨颈骨折后创伤性畸形愈合总是会导致疼痛性功能障碍。在初次手术干预时进行解剖复位和确切、稳定的骨固定是预防措施。如果距周关节没有出现关节病,应考虑进行保留关节的二期解剖重建。当畸形导致关节不匹配并最终引发创伤后关节炎时,应考虑进行重新定向关节融合术。全踝关节置换术(TAA)作为一种保留运动功能的手术,可与相邻的距下关节和中跗关节融合术联合应用。