Tinner Christian, Sommer Christoph
Departement of Surgery, Kantonsspital Graubünden, Loëstrasse 170, Chur 7000, Switzerland.
Departement of Surgery, Kantonsspital Graubünden, Loëstrasse 170, Chur 7000, Switzerland.
Foot Ankle Clin. 2018 Sep;23(3):375-395. doi: 10.1016/j.fcl.2018.04.009.
Lateral talar process fractures (LTPF) are uncommon injuries but have become more relevant with snowboarding. Currently the fractures are classified according to McCrory-Bladin into 3 types, with advice for treatment that is not ideal anymore. This article proposes modifying the existing classification by differentiating the multifragmented type III into 3 subtypes: IIIa, articular multifragmented but metaphyseal simple; IIIb, articular and metaphyseal multifragmented but reconstructable; and type IIIc, comminuted and nonreconstructable. A treatment-algorithm is presented. Undisplaced fractures are usually treated conservatively and displaced are an indication for surgery. In general, the outcome is good to excellent, if timely diagnosed and adequately treated.
距骨外侧突骨折（LTPF）并不常见，但随着单板滑雪运动的兴起，其相关性日益增加。目前，根据麦克罗里-布莱丁分类法，这些骨折被分为3种类型，但其治疗建议已不再理想。本文建议对现有分类进行修改，将多碎片型III型细分为3个亚型：IIIa型，关节面多碎片但干骺端简单；IIIb型，关节面和干骺端多碎片但可重建；IIIc型，粉碎性且不可重建。本文还提出了一种治疗算法。无移位骨折通常采用保守治疗，移位骨折则需手术治疗。一般来说，如果能及时诊断并得到充分治疗，预后良好至极佳。
