Leung K S, Chan W S, Shen W Y, Pak P P, So W S, Leung P C
Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong.
J Orthop Trauma. 1989;3(3):232-40. doi: 10.1097/00005131-198909000-00008.
The treatment of intraarticular fractures of the os calcis remains controversial. Yet it seems illogical that the subtalar joints should be treated differently from other weight-bearing joints. In this paper, we report the results of treating 64 intraarticular fractures of the os calcis by open reduction, rigid internal fixation with primary bone graft, and early mobilization. Of the 64 fractures, 23.43% were tongue-type fractures, 48.43% were joint depression, and 28.12% were comminuted. All the fractures were operated on with lateral incisions. The average period of follow-up was 10.6 months. The results showed that all the patients had minimal pain, swelling, and deformity. Subtalar joint movement was retained (67.8% of active and 80.7% of passive). Eighty percent of normal Bohler angles and 93.5% of normal crucial angles were regained. Over 80% of patients resumed working within 6 months after the injuries. We therefore concluded that the present method of treating intraarticular fractures of os calcis gives very good results.
跟骨关节内骨折的治疗仍存在争议。然而，距下关节与其他负重关节的治疗方式不同，这似乎不合逻辑。在本文中，我们报告了采用切开复位、一期植骨坚强内固定及早期活动治疗64例跟骨关节内骨折的结果。64例骨折中，舌型骨折占23.43%，关节塌陷型占48.43%，粉碎性骨折占28.12%。所有骨折均采用外侧切口进行手术。平均随访时间为10.6个月。结果显示，所有患者的疼痛、肿胀及畸形均轻微。距下关节活动得以保留（主动活动保留67.8%，被动活动保留80.7%）。恢复了80%的正常Bohler角和93.5%的正常关键角。超过80%的患者在受伤后6个月内恢复工作。因此，我们得出结论，目前治疗跟骨关节内骨折的方法效果良好。
