Xu Mingliang, Li Renlong, Chen Guoliang, Zhou Xiangguo, Wei Di, Cao Guangchao, Shi Rongjian
Department of Foot and Ankle Surgery, Xuzhou Renci Hospital, Xuzhou Economic and Technological Development Zone, No. 11, Yangshan Road, Xuzhou, 221000, Jiangsu, China.
Int Orthop. 2024 Feb;48(2):573-580. doi: 10.1007/s00264-023-06006-2. Epub 2023 Oct 14.
A fracture of the posterior talar process is easily missed because of its hidden position. Inappropriate treatment is likely to result in complications, such as nonunion of the fracture and traumatic arthritis. This study evaluated the outcomes of arthroscopy-assisted reduction combined with robotic-assisted screw placement in the treatment of fractures of the posterior talar process.
The clinical data for nine patients who underwent surgical treatment of a fracture of the posterior talar process at our institution between September 2017 and January 2021 were retrospectively reviewed. Arthroscopy-assisted reduction of the fracture was performed, and a cannulated screw was placed using three-dimensional orthopedic robotic-assisted navigation.
The patients (seven men, two women) had a mean age of 36.33 ± 9.77 years and were followed up for 21 ± 5.43 months. The operation time was 106.67 ± 24.5 min with blood loss of 47.78 ± 9.05 ml. Primary healing was obtained in all cases, and no patient sustained a nerve or tendon injury, had fracture nonunion, or developed talar osteonecrosis. One patient developed subtalar arthritis, for which subtalar joint fusion was performed; pain was markedly less severe after cleaning.
Arthroscopy-assisted reduction and robotic-assisted screw placement have the advantages of visualization of fracture reduction, minimal injury, and precise screw placement in the treatment of fractures of the posterior talar process.
距骨后突骨折因其位置隐匿，容易被漏诊。治疗不当可能导致诸如骨折不愈合和创伤性关节炎等并发症。本研究评估了关节镜辅助复位联合机器人辅助螺钉置入治疗距骨后突骨折的疗效。
回顾性分析2017年9月至2021年1月在我院接受距骨后突骨折手术治疗的9例患者的临床资料。采用关节镜辅助骨折复位，并使用三维骨科机器人辅助导航置入空心螺钉。
患者（7例男性，2例女性）平均年龄36.33±9.77岁，随访21±5.43个月。手术时间为106.67±24.5分钟，出血量为47.78±9.05毫升。所有病例均获得一期愈合，无患者发生神经或肌腱损伤、骨折不愈合或距骨坏死。1例患者发生距下关节炎，行距下关节融合术；清理后疼痛明显减轻。
关节镜辅助复位和机器人辅助螺钉置入在治疗距骨后突骨折方面具有骨折复位可视化、损伤小和螺钉置入精确的优点。
