Schöntag H, Schöttle H, Dallek M
Langenbecks Arch Chir. 1981;354(3):221-9. doi: 10.1007/BF01254557.
Because of the anatomical and functional peculiarities of the astragallus surgical and conservative treatment of central fractures are often unsatisfactory. A follow-up study of 40 patients with 42 central talus fractures were performed over an average of 9 years after the initial trauma. The number of poor results was extremely high; only primary surgical or conservative treatment showed good or fair results. Best results were obtained by primary surgical treatment whereas fractures operated at later stages showed worse results. Therefore fresh central astragallus fractures should be operated upon, fractures older than 1 day should be treated conservatively. If a satisfactory reduction cannot be obtained, the fracture should be operated upon in order to prevent arthrosis in the upper ankle joint.
由于距骨的解剖和功能特性，中央型骨折的手术治疗和保守治疗往往不尽人意。对40例（共42处）距骨中央型骨折患者进行了随访研究，平均随访时间为初次创伤后的9年。结果不佳的比例极高；只有初次手术或保守治疗显示出良好或尚可的结果。初次手术治疗取得了最佳效果，而后期手术的骨折效果较差。因此，新鲜的距骨中央型骨折应进行手术治疗，超过1天的骨折应进行保守治疗。如果无法获得满意的复位，则应进行手术以防止踝关节上方出现关节病。
