Thermann H, Ansar M, Tscherne H
Zentrum für Knie- und Fußchirurgie, ATOS-Klinik Heidelberg, Germany.
Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Germany.
Orthopade. 1999 Jun;28(6):518-528. doi: 10.1007/PL00003637.
Peripheral talar fractures are frequently overlooked and should be considered in the differential diagnosis of patients with acute and chronic ankle pain. Early diagnosis allows specific treatment options to prevent long-term complications and enables better overall results. Computertomography is obligatory for definite evaluation of the pathology and to determine the need for conservative or operative treatment. Conservatively treated displaced fractures lead to pain and decreased range of motion from ongoing arthrosis of the subtalar joint. Large or displaced fragments require, according to the scare literature, open reduction and internal fixation. Comminution or small fragments are best addressed by surgical excision, although alteration in the biomechanics of the subtalar joint may occur.
距骨周围骨折常被忽视，在急慢性踝关节疼痛患者的鉴别诊断中应予以考虑。早期诊断有助于选择特定的治疗方案以预防长期并发症，并能取得更好的总体效果。计算机断层扫描对于明确病变评估以及确定保守或手术治疗的必要性是必不可少的。保守治疗移位骨折会因距下关节持续的关节炎而导致疼痛和活动范围减小。根据有限的文献资料，大的或移位的骨折块需要切开复位内固定。粉碎性骨折或小骨折块最好通过手术切除处理，尽管可能会发生距下关节生物力学改变。
