Shakked Rachel J, Tejwani Nirmal C
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA.
Orthop Clin North Am. 2013 Oct;44(4):521-8. doi: 10.1016/j.ocl.2013.06.007. Epub 2013 Aug 12.
Talus fractures result from high-energy mechanisms and usually occur at the neck. Functional outcome after talar neck fracture worsens with increasing Hawkins grade. The mainstay of treatment for talar neck fractures is anatomic reduction and internal fixation. Prompt reduction of dislocations should be performed. Patients should be taken to the operating room as soon as stabilized. Dual incisions and a combination of minifragment plates and screws should be used. Talar body fractures have a high rate of ankle and subtalar arthritis. Lateral process fractures are frequently missed on radiographs. Complications after talus fractures include osteonecrosis, malunion, post-traumatic arthritis, and infection.
距骨骨折由高能机制导致，通常发生在颈部。距骨颈骨折后的功能预后随霍金斯分级增加而恶化。距骨颈骨折的主要治疗方法是解剖复位和内固定。应及时进行脱位复位。患者病情一旦稳定，应尽快送往手术室。应采用双切口以及微型接骨板和螺钉联合使用。距骨体骨折导致踝关节和距下关节炎的发生率很高。外侧突骨折在X线片上经常漏诊。距骨骨折后的并发症包括骨坏死、畸形愈合、创伤后关节炎和感染。
