Ketz John, Clare Michael, Sanders Roy
Department of Orthopaedic Surgery, University of Rochester, 601 Elmwood Ave., Box 665, Rochester, NY 14642, USA.
University of South Florida Department of Orthopaedic Surgery, Florida Orthopaedic Institute, 13020 Telecom Parkway North, Tampa, FL 33637, USA.
Foot Ankle Clin. 2016 Mar;21(1):135-45. doi: 10.1016/j.fcl.2015.09.006.
The most effective way to treat calcaneal malunions is avoidance. With any articular fracture, progressive arthrosis and dysfunction are common. By restoring the anatomy initially through reduction, late reconstructive options become less complicated. Numerous studies have shown that restoration of the anatomic alignment either through percutaneous or open techniques is effective. In patients with no or minimal articular degeneration, extrarticular joint-sparing procedures can be performed. This represents a small select group who may benefit from simple osteotomy procedures with associated soft tissue reconstruction, if needed.
治疗跟骨畸形愈合最有效的方法是预防。对于任何关节骨折,渐进性关节病和功能障碍都很常见。通过复位最初恢复解剖结构,后期重建选择会变得不那么复杂。大量研究表明,通过经皮或开放技术恢复解剖对线是有效的。在没有或仅有轻微关节退变的患者中,可以进行关节外保留关节的手术。这是一小部分特定人群,如果需要,他们可能受益于简单的截骨手术及相关软组织重建。