Burdeaux B D
Clin Orthop Relat Res. 1983 Jul-Aug(177):87-103.
Most calcaneal fractures are of the joint depression type or the tongue type, both of which are amenable to reduction by the medial approach technique. This procedure is based on the principle of restoring the medial wall of the calcaneus, which must be done from the medial side. An accurate reduction produces stability, restores length and height, and partially restores width. The joint depression- or tongue-type fragment is reduced to restore the articular surface of the posterior facet. Many of these fractures can be reduced from the medial side. However, if necessary, a lateral incision should also be made for accurate replacement of these fragments. The final restoration of calcaneal width is accomplished by reducing the lateral bulge of the tuberosity by applying direct pressure over the lateral heel. This deformity, which produces morbidity, must be completely reduced. The medial approach technique offers an opportunity to reduce each of the deformities of the depressed calcaneal fracture. The method is recommended.
大多数跟骨骨折为关节塌陷型或舌型，这两种类型均适合采用内侧入路技术进行复位。该手术基于恢复跟骨内侧壁的原则，而这必须从内侧进行。精确复位可产生稳定性，恢复长度和高度，并部分恢复宽度。将关节塌陷型或舌型骨折块复位以恢复后关节面。许多此类骨折可从内侧进行复位。然而，如有必要，也应做外侧切口以便精确复位这些骨折块。通过在足跟外侧施加直接压力来减少结节的外侧膨出，从而实现跟骨宽度的最终恢复。这种导致发病的畸形必须完全矫正。内侧入路技术为矫正跟骨凹陷骨折的各种畸形提供了机会。推荐使用该方法。
