Sangeorzan B J, Benirschke S K, Mosca V, Mayo K A, Hansen S T
Department of Orthopaedic Surgery, University of Washington, Harborview Medical Center, Seattle 98104.
J Bone Joint Surg Am. 1989 Dec;71(10):1504-10.
Between 1980 and 1987, twenty-one patients who had a displaced fracture of the body of the tarsal navicular were treated with open reduction and internal fixation. A classification system was devised on the basis of the direction of the fracture line, the pattern of disruption of the surrounding joints, and the direction of displacement of the foot. In a Type-1 injury, the fracture line is in the coronal plane and there is no angulation of the fore part of the foot. In a Type-2 fracture, the primary fracture line is dorsal-lateral to plantar-medial, and the major fragment and the fore part of the foot are displaced medially. In a Type-3 injury, there is a comminuted fracture in the sagittal plane of the body of the tarsal navicular, and the fore part of the foot is laterally displaced. Satisfactory reduction, which was defined as restoration of more than 60 per cent of the joint surface in the anteroposterior and lateral planes, was achieved in all Type-1 injuries, 67 per cent of the Type-2 fractures, and 50 per cent of the Type-3 fractures. Radiographic evidence of healing was seen at an average of 8.5 weeks after injury. At an average follow-up of forty-four months (range, twelve to 106 months), a good result was noted in fourteen patients (67 per cent); a fair result, in four (19 per cent); and a poor result, in three (14 per cent). Both the type of fracture and the accuracy of the operative reduction directly correlated with the final clinical outcome.
1980年至1987年间，21例距骨体移位骨折患者接受了切开复位内固定治疗。基于骨折线方向、周围关节破坏模式以及足部移位方向设计了一种分类系统。在1型损伤中，骨折线位于冠状面，足部前部无成角。在2型骨折中，主要骨折线从背外侧至跖内侧，主要骨折块和足部前部向内移位。在3型损伤中，距骨体矢状面存在粉碎性骨折，足部前部向外移位。所有1型损伤、67%的2型骨折和50%的3型骨折均实现了满意的复位，满意复位定义为前后位和侧位关节面恢复超过60%。损伤后平均8.5周可见愈合的影像学证据。平均随访44个月（范围12至106个月），14例患者（67%）结果良好；4例（19%）结果一般；3例（14%）结果较差。骨折类型和手术复位的准确性均与最终临床结果直接相关。
