Egger Anthony C, Berkowitz Mark J
1 Department of Orthopedics, Cleveland Clinic Foundation, Cleveland, OH, USA.
Foot Ankle Int. 2018 Oct;39(10):1242-1252. doi: 10.1177/1071100718795630. Epub 2018 Aug 30.
Failure to anatomically reduce and stabilize the fractured distal fibula can result in malunion of the fibula and malreduction of the ankle mortise. Fibular malunion results in altered ankle joint biomechanics which often leads to the development of pain, stiffness, and premature joint degeneration. Fortunately, many fibular malunions can be successfully salvaged using osteotomy techniques to restore anatomic fibular length and rotation. Different osteotomy techniques are indicated depending on the location and characteristics of the malunion. In this review, the oblique fibular osteotomy is described for the reconstruction of SER-type fibular fractures. For more proximal fibular malunion, the transverse osteotomy technique with lengthening and structural bone graft is reviewed.
Level V, expert opinion.
未能在解剖学上复位并稳定腓骨远端骨折可导致腓骨畸形愈合和踝关节 mortise 复位不良。腓骨畸形愈合会导致踝关节生物力学改变,常引发疼痛、僵硬和关节过早退变。幸运的是,许多腓骨畸形愈合可通过截骨技术成功挽救,以恢复腓骨的解剖长度和旋转。根据畸形愈合的位置和特点,可采用不同的截骨技术。在本综述中,描述了用于重建 SER 型腓骨骨折的斜行腓骨截骨术。对于更靠近近端的腓骨畸形愈合,回顾了采用延长和结构性骨移植的横行截骨技术。
V 级,专家意见。