Gotha Heather E, Zide Jacob R
Department of Orthopaedic Surgery, Baylor University Medical Center, 3900 Junius Street, Suite 500, Dallas, TX 75246, USA.
Department of Orthopaedic Surgery, Baylor University Medical Center, 3900 Junius Street, Suite 500, Dallas, TX 75246, USA.
Orthop Clin North Am. 2017 Jan;48(1):91-103. doi: 10.1016/j.ocl.2016.08.005. Epub 2016 Oct 28.
Displaced intraarticular fractures of the calcaneus represent a technically challenging injury. Although there is conflicting evidence regarding advantages and disadvantages of operative versus nonoperative treatment, a growing body of literature suggests operative management with near-anatomic reduction of the posterior facet and restoration of overall calcaneal morphology offers greater potential for superior short- and long-term outcomes. A thorough understanding of calcaneal anatomy, fracture pattern, and associated injuries, along with careful selection of surgical approach and timing to surgery are critical to minimize the risk of complication and maximize potential for optimal outcomes.
跟骨移位性关节内骨折是一种技术上具有挑战性的损伤。尽管关于手术治疗与非手术治疗的优缺点存在相互矛盾的证据,但越来越多的文献表明,对后关节面进行近乎解剖复位并恢复跟骨整体形态的手术治疗,在短期和长期都更有可能取得更好的效果。深入了解跟骨解剖结构、骨折类型及相关损伤,同时仔细选择手术入路和手术时机,对于将并发症风险降至最低并最大限度提高取得最佳疗效的可能性至关重要。