Sposeto Rafael Barban, Matías-Joannas Germán, Godoy-Santos Alexandre Leme
Departamento de Ortopedia e Traumatologia, Instituto de Ortopedia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, SP, Brasil.
Divisão de Pé e Tornozelo, Centro de Estudios y Práctica Profesional (CEPP), Instituto Dupuytren, Buenos Aires, Argentina.
Rev Bras Ortop (Sao Paulo). 2025 Jul 29;60(3):1-9. doi: 10.1055/s-0045-1809887. eCollection 2025 Jun.
Intra-articular calcaneal fractures are significant injuries to the locomotor system, often leading to lifelong impairments in foot mechanics with substantial occupational, social, and financial repercussions. The initial imaging diagnosis relies on radiography; however, computed tomography is crucial for understanding the three-dimensional anatomy of the fracture and facilitating surgical planning.The treatment of intra-articular calcaneal fractures remains a subject of debate, with literature supporting diverse approaches for similar fracture types. Currently, the gold standard for managing subtalar joint fractures is surgical intervention. Among the two most common techniques, the extended lateral and the sinus tarsi approaches yield comparable functional outcomes, though the latter is associated with fewer complications.The present article discusses the diagnosis, classification, and treatment of intra-articular calcaneal fractures, focusing on the sinus tarsi and extended lateral "L" approaches, as well as the fixation techniques applicable to each fracture type.
跟骨关节内骨折是运动系统的严重损伤，常常导致足部力学的终身损害，并产生重大的职业、社会和经济影响。初始影像学诊断依赖于X线摄影；然而，计算机断层扫描对于了解骨折的三维解剖结构和辅助手术规划至关重要。跟骨关节内骨折的治疗仍是一个有争议的话题，文献支持针对相似骨折类型的多种治疗方法。目前，距下关节骨折治疗的金标准是手术干预。在两种最常用的技术中，扩大外侧入路和跗骨窦入路产生的功能结果相当，尽管后者的并发症较少。本文讨论跟骨关节内骨折的诊断、分类和治疗，重点关注跗骨窦和扩大外侧“L”形入路，以及适用于每种骨折类型的固定技术。
