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[距骨周围骨折:概述]

[Peripheral fractures of the talus : An overview].

作者信息

Baumbach Sebastian F, Böcker Wolfgang, Polzer Hans

机构信息

OrthoPlus, Lehnbachplatz 2a, 80333, München, Deutschland.

Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, LMU München, München, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2025 Aug;128(8):611-622. doi: 10.1007/s00113-025-01595-6. Epub 2025 Jun 26.

DOI:10.1007/s00113-025-01595-6
PMID:40569362
Abstract

Fractures of the talar head, lateral tubercle of the talus and posterior tubercle of the talus are summarized under the term peripheral talar fractures. These injuries are rare and are often overlooked on conventional X‑rays, which is why they are often diagnosed after a delay. When overlooked they are very likely to lead to poorer outcomes. In all cases where an injury is suspected computed tomography (CT) imaging should be carried out to detect or exclude a peripheral talar fracture and concomitant injuries and to understand the injury. Nonoperative treatment can be used for nondisplaced fractures, excision can be considered for small displaced fragments and open reduction and internal fixation should be considered for displaced fragments of sufficient size. The surgical approach is based on the morphological characteristics of the fracture and the localization. Due to the scarce evidence available treatment recommendations are based solely on expert opinions.

摘要

距骨头骨折、距骨外侧结节骨折和距骨后结节骨折统称为距骨周围骨折。这些损伤较为罕见,在传统X线片上常被忽视,这就是它们经常被延迟诊断的原因。一旦被忽视,很可能导致较差的预后。在所有疑似损伤的病例中,都应进行计算机断层扫描(CT)成像,以检测或排除距骨周围骨折及合并损伤,并了解损伤情况。无移位骨折可采用非手术治疗,小的移位碎片可考虑切除,足够大的移位碎片应考虑切开复位内固定。手术入路基于骨折的形态特征和部位。由于现有证据不足,治疗建议仅基于专家意见。

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1
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本文引用的文献

1
Beyond the imaging evaluation of fractures of the lateral process of the talus: Let's not forget concomitant injuries.距骨外侧突骨折的影像学评估之外:我们不要忘记合并损伤。
World J Clin Cases. 2024 Oct 26;12(30):6410-6412. doi: 10.12998/wjcc.v12.i30.6410.
2
Talar head fractures: An observational study of 33 talar head fractures derived from the Swedish Fracture Register.距骨头部骨折:来自瑞典骨折登记处的 33 例距骨头部骨折的观察性研究。
Injury. 2024 Nov;55(11):111861. doi: 10.1016/j.injury.2024.111861. Epub 2024 Sep 6.
3
Arthroscopic reduction and internal fixation for fracture of the posterior process of the talus (Shepherd's fracture): a case report.
关节镜下复位内固定治疗距骨后突骨折(Shepherd 骨折):病例报告。
J Med Case Rep. 2024 Jul 30;18(1):347. doi: 10.1186/s13256-024-04652-7.
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Management and classification of the fracture of lateral process of talus: An overview and literature update.距骨外侧突骨折的管理与分类:综述及文献更新
World J Clin Cases. 2024 May 26;12(15):2487-2498. doi: 10.12998/wjcc.v12.i15.2487.
5
Three-dimensional Mapping Analysis of Talus Fractures and Demonstration of Different Surgical Approaches for Talus Fractures.距骨骨折的三维测绘分析及不同手术入路治疗距骨骨折的疗效展示。
Orthop Surg. 2024 May;16(5):1196-1206. doi: 10.1111/os.14033. Epub 2024 Mar 14.
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[Fractures of the talar neck and body : An overview].[距骨颈和体部骨折:概述]
Unfallchirurgie (Heidelb). 2023 Jun;126(6):485-497. doi: 10.1007/s00113-023-01330-z. Epub 2023 May 24.
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9
Functional Outcome and Quality of Life After Nonoperative Treatment of Posterior Process Fractures of the Talus.距骨后突骨折非手术治疗的功能结果和生活质量。
Foot Ankle Int. 2019 Dec;40(12):1403-1407. doi: 10.1177/1071100719868712. Epub 2019 Aug 23.
10
Clinical outcome and concomitant injuries in operatively treated fractures of the lateral process of the talus.手术治疗外踝突骨折的临床结果和伴随损伤。
BMC Musculoskelet Disord. 2019 May 15;20(1):219. doi: 10.1186/s12891-019-2603-3.