Grob D, Simpson L A, Weber B G, Bray T
Clin Orthop Relat Res. 1985 Oct(199):88-96.
The talus is a bone with unique biomechanical features and vascular supply. Displaced fractures of the talus, therefore, frequently create problems of proper management. Forty-one severe talar fractures were treated operatively. The incidence of avascular necrosis was relatively low in this series (16%), and all of these were of Type III and IV fractures of the Marti-Weber classification. Type IV fractures were successfully treated by arthrodesis per primam, and suggested that fusion may be the indicated method of treatment in these severe injuries. Fusion of the tibiotalar joint has been used to encourage revascularization and to preserve the important function of the subtalar joint. In all other fracture types with dislocation, anatomic reduction is performed to restore joint congruity and encourage maintenance of talar dome viability. Painstaking postoperative management is important for the complete restoration of function.
距骨是一块具有独特生物力学特征和血供的骨头。因此，距骨移位骨折常常给恰当的治疗带来问题。对41例严重距骨骨折进行了手术治疗。在本系列中，缺血性坏死的发生率相对较低（16%），且所有这些均为Marti-Weber分类的III型和IV型骨折。IV型骨折通过一期关节融合术成功治疗，这表明融合术可能是这些严重损伤的指定治疗方法。胫距关节融合术已被用于促进血管再生并保留距下关节的重要功能。在所有其他伴有脱位的骨折类型中，进行解剖复位以恢复关节一致性并促进距骨穹窿活力的维持。精心的术后管理对于功能的完全恢复很重要。
