Rathjen J, Völlmecke M, Bieler D, Franke A, Kollig E
Klinik für Unfallchirurgie und Orthopädie, Hand- und Wiederherstellungschirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacherstraße 170, 56072, Koblenz, Deutschland.
Unfallchirurgie (Heidelb). 2024 Feb;127(2):151-159. doi: 10.1007/s00113-023-01365-2. Epub 2023 Oct 24.
The standard surgical procedure for complex calcaneal fractures is open reduction, internal reduction and internal stable angle plate osteosynthesis via a lateral approach. More recently, options for minimally invasive and percutaneous surgical strategies have been presented [4, 7]. As a possible procedural alternative for a covered, surgical treatment of calcaneal fractures, calcaneoplasty is discussed and applied in this context [5]. In this case series of five complex calcaneal fractures presented here, a balloon catheter was used for percutaneous reduction to restore the alignment of the calcaneus.This was followed by placement of PMMA cement in radiofrequency application and osteosynthesis using percutaneous cannulated screws. This Vicenti technique allows stable reduction and retention with early partial weight bearing with an overall low complication rate [17].
复杂跟骨骨折的标准外科手术是通过外侧入路进行切开复位、内固定和使用内固定稳定角钢板进行接骨术。最近，已经提出了微创和经皮手术策略的选择[4,7]。作为一种可能的程序性替代方法，用于隐蔽性跟骨骨折的手术治疗，在此背景下讨论并应用了跟骨成形术[5]。在本文介绍的这例包含五例复杂跟骨骨折的病例系列中，使用球囊导管进行经皮复位以恢复跟骨的对线。随后在射频应用中置入聚甲基丙烯酸甲酯骨水泥，并使用经皮空心螺钉进行接骨术。这种维森蒂技术能够实现稳定复位和固定，并允许早期部分负重，总体并发症发生率较低[17]。
