Roukis Thomas S
Orthopaedic Center, Gundersen Health System, 1900 South Avenue, La Crosse, WI 54601, USA.
Clin Podiatr Med Surg. 2019 Apr;36(2):251-268. doi: 10.1016/j.cpm.2018.10.007. Epub 2019 Jan 24.
Displaced intra-articular calcaneal fractures represent life-altering injuries. Difficulty obtaining and maintaining calcaneal morphology and the significant risk of wound healing complications with an extensile lateral incision exist. Open reduction with internal fixation as a joint-sparing approach has been studied. Closed manipulation to restore calcaneal morphology, intra-osseous fracture reduction, and rigid locked CALCANAIL fracture nail fixation have recently been applied to Sanders IV fracture patterns. Spontaneous conversion to primary subtalar joint arthrodesis using the same instrumentation remains unique to this system. This article reviews open and percutaneous approaches for joint-sparing and primary arthrodesis procedures to treat Sanders IV fracture patterns.
移位的关节内跟骨骨折是改变生活的损伤。获取并维持跟骨形态存在困难，且采用外侧延长切口会有伤口愈合并发症的重大风险。作为一种保留关节的方法，切开复位内固定已得到研究。闭合手法复位以恢复跟骨形态、骨内骨折复位以及使用跟骨锁定骨折钉进行坚强内固定，最近已应用于Sanders IV型骨折模式。使用相同器械自发转换为一期距下关节融合术是该系统独有的。本文回顾了用于治疗Sanders IV型骨折模式的保留关节和一期融合手术的开放和经皮入路。
