Bégué T, Mebtouche N, Auregan J-C, Saintyves G, Levante S, Cottin P, Masquelet A-C
Orthopaedic and Trauma Surgery Department, hôpital Antoine-Béclère, université Paris-Sud, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Orthopaedic and Trauma Surgery Department, hôpital Antoine-Béclère, université Paris-Sud, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Orthop Traumatol Surg Res. 2014 Jun;100(4):429-32. doi: 10.1016/j.otsr.2014.01.008. Epub 2014 Apr 13.
The optimal treatment for intra-articular calcaneus fractures remains controversial, despite internal fixation techniques providing good results. The major point of contention is the need to reconstruct the overall morphology versus to restore the anatomy of the subtalar joint perfectly. We will describe a two-stage technique for treating intra-articular calcaneus fractures in which the primary fracture line goes through the thalamic fragment. The first procedure focuses on the overall morphology by restoring the height and length with osteotaxis being accomplished with a medial external fixator. The second procedure consists of internal fixation through a minimally invasive lateral approach to restore the anatomy of the articular facets. Any defects are filled with injectable bone substitute. This novel technique is compared to the complication rates and radiology and anatomy outcomes in published studies. This two-stage surgical technique reduces the length of hospital stays and the number of complications.
尽管内固定技术取得了良好效果，但跟骨关节内骨折的最佳治疗方法仍存在争议。主要争议点在于，是需要重建整体形态，还是完美恢复距下关节的解剖结构。我们将描述一种分两阶段治疗跟骨关节内骨折的技术，其中主要骨折线穿过丘脑碎片。第一步通过使用内侧外固定器进行骨牵引来恢复高度和长度，着重于整体形态。第二步包括通过微创外侧入路进行内固定，以恢复关节面的解剖结构。任何缺损都用可注射骨替代物填充。将这种新技术与已发表研究中的并发症发生率、放射学和解剖学结果进行比较。这种两阶段手术技术减少了住院时间和并发症数量。
