Githens Michael, Shatsky Joshua, Agel Julie, Bransford Richard J, Benirschke Stephen K
Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017727915. doi: 10.1177/2309499017727915.
The derangement in calcaneal morphology after a fracture can be significant and is often associated with severe soft tissue envelop problems. Medial calcaneal external fixation is useful for early restoration of calcaneal morphology and the corresponding soft tissue envelop. When performed in a stepwise fashion, external fixation can successfully restore normal calcaneal height, length, width, and coronal plane alignment. For severely displaced joint depression and broken tongue-type calcaneus fractures where open treatment is the preferred strategy, early external fixation restores the normal soft tissue tension, allows a stable environment for soft tissue recovery, and facilitates the definitive operation by restoring and maintaining overall calcaneal architecture. We describe the stepwise approach to calcaneal reduction and external fixation and report a case series demonstrating this method is safe and effective for staged management of severely displaced calcaneus fractures.
骨折后跟骨形态的紊乱可能很严重，且常伴有严重的软组织包膜问题。跟骨内侧外固定有助于早期恢复跟骨形态及相应的软组织包膜。当按分步方式进行时，外固定可成功恢复跟骨的正常高度、长度、宽度及冠状面排列。对于严重移位的关节塌陷型和舌形跟骨骨折，开放治疗是首选策略，早期外固定可恢复正常的软组织张力，为软组织恢复提供稳定环境，并通过恢复和维持跟骨整体结构促进确定性手术。我们描述了跟骨复位和外固定的分步方法，并报告了一个病例系列，证明该方法对严重移位跟骨骨折的分期治疗是安全有效的。
