Department of Orthopedic Surgery, University of Colorado School of Medicine, 12631 East 17th Avenue, Room 4508, Aurora, CO 80045, USA; Bellin Health Titletown Sports Medicine and Orthopedics, 1970 South Ridge Road, Green Bay, WI 54304, USA.
University of Colorado, Foot and Ankle Clinics of N. America, Steps2Walk, 11026 East Crestline Circle, Englewood, CO 80111, USA.
Foot Ankle Clin. 2022 Dec;27(4):787-803. doi: 10.1016/j.fcl.2022.08.001.
Subtalar joint arthrosis is common following intra-articular calcaneus fractures. The appropriate management of pain secondary to posttraumatic arthritis depends on the status of the remaining posterior facet articular cartilage, the magnitude of any residual joint displacement and distortions in the overall morphology of the calcaneus. In select circumstances, joint-preserving surgical techniques may be considered including lateral wall exostectomy, far lateral posterior facet joint debridement, and intra-articular osteotomies. When the subtalar joint is not salvageable, some form of arthrodesis procedure is pursued. Occasionally, an extra-articular osteotomy may be necessary in combination with arthrodesis to correct deformity.
距下关节关节炎在跗骨关节内骨折后很常见。创伤后关节炎引起的疼痛的适当处理取决于后关节面关节软骨的剩余情况、任何残余关节移位的程度以及跟骨整体形态的扭曲。在某些情况下，可以考虑采用保留关节的手术技术，包括外侧壁切除术、远外侧后关节面关节清理术和关节内截骨术。当距下关节无法挽救时，会采用某种形式的关节融合术。偶尔，需要结合关节融合术进行关节外截骨术来矫正畸形。
