Saß M, Rotter R, Mittlmeier T
Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Germany.
Oper Orthop Traumatol. 2019 Apr;31(2):149-164. doi: 10.1007/s00064-018-0576-2. Epub 2018 Nov 9.
A minimally invasive technique to prevent soft tissue problems using a calcaneal nail (Calcanail®, FH Orthopedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint arthrodesis is described.
Displaced extra-articular calcaneal fractures involving the tuberosity fragment and in displaced intra-articular calcaneal fractures with impression and/or displacement of the subtalar joint surface. Subtalar joint arthrodesis for posttraumatic subtalar osteoarthritis.
Severely displaced fractures type Sanders IV with the purpose of internal fixation; peripheral calcaneal fractures; general contraindications for operative treatment.
Minimally invasive reduction of calcaneal fractures using a special distractor and a graft pusher through a calcaneal working channel. Fixation performed via the insertion of the Calcanail® and the two locking screws, optional additional screws. Subtalar joint arthrodesis with a Calcanail® used with optional three locking screws to fix the talus and calcaneus creating an angular stable construct.
Mobilization and restricted weight-bearing for 6 weeks in the patient's own shoes after fracture fixation or in a walker after arthrodesis.
Preliminary results of 69 cases from three surgical centers have already been published. From 2013-2017, the technique was used in 48 of our own patients (42 calcaneal fracture reduction and fixation; 6 for subtalar joint arthrodesis). Mean postoperative hospital stay was 7 days for fracture reduction without any need of additional operations. During follow-up, 6 implant removals and 2 secondary subtalar fusions were noticed. All 6 cases of subtalar joint arthrodesis were planned in posttraumatic subtalar osteoarthritis.
描述一种使用跟骨钉（Calcanail®，FH Orthopedics，法国海姆斯布伦）预防软组织问题的微创技术，用于跟骨骨折或距下关节融合术。
累及结节骨折块的移位关节外跟骨骨折，以及距下关节面有压痕和/或移位的移位关节内跟骨骨折。创伤后距下骨关节炎的距下关节融合术。
严重移位的Sanders IV型骨折用于内固定；跟骨周围骨折；手术治疗的一般禁忌症。
通过跟骨工作通道，使用特殊牵开器和植骨推压器对跟骨骨折进行微创复位。通过插入Calcanail®和两枚锁定螺钉进行固定，可选择额外的螺钉。使用Calcanail®进行距下关节融合术，可选择三枚锁定螺钉固定距骨和跟骨，形成角稳定结构。
骨折固定后患者穿自己的鞋子活动并限制负重6周，或在关节融合术后使用助行器。
来自三个手术中心的69例初步结果已经发表。2013年至2017年，我们自己的48例患者采用了该技术（42例跟骨骨折复位固定；6例距下关节融合术）。骨折复位术后平均住院时间为7天，无需额外手术。随访期间，发现6例取出植入物和2例二次距下融合。所有6例距下关节融合术均用于创伤后距下骨关节炎。
