Heinig Ofer, Feicht Elia, Mahamid Assil, Liberson Roman, Picard Claude, Liberson Aharon
Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Trauma Case Rep. 2023 May 20;46:100850. doi: 10.1016/j.tcr.2023.100850. eCollection 2023 Aug.
Compound Gustilo-type III intra-articular calcaneus fractures are challenging to treat. Anatomical reduction of the subtalar joint increases the chances of a better functional outcome and is traditionally achieved by an open reduction and plating. Conversely, ORIF is associated with a high risk of infection and even amputation. In our case study, we present the treatment of a Gustilo-type III intra-articular calcaneus fracture with a circular external fixator and a temporary antibiotic cement spacer for fracture reduction and stabilization. Active bio-glass was implanted to fill bone loss and to prevent infection. A closing-wedge calcaneal tuberosity osteotomy was used to facilitate wound closure. We paid special attention to reducing the posterior facet. The patient returned to work and full ambulation five months post-injury.
复合型 Gustilo Ⅲ型关节内跟骨骨折的治疗具有挑战性。距下关节的解剖复位可增加获得更好功能预后的机会，传统上是通过切开复位和钢板固定来实现的。相反，切开复位内固定术（ORIF）伴有较高的感染甚至截肢风险。在我们的病例研究中，我们展示了使用环形外固定器和临时抗生素骨水泥间隔物治疗 Gustilo Ⅲ型关节内跟骨骨折以实现骨折复位和稳定。植入活性生物玻璃以填充骨缺损并预防感染。采用闭合楔形跟骨结节截骨术以利于伤口闭合。我们特别注意复位后关节面。患者在受伤后五个月恢复工作并完全行走。
