Alexander A H, Lichtman D M
J Bone Joint Surg Am. 1980;62(4):646-52.
Experience with forty-nine patients with surgically treated transchondral fractures of the talar dome seen between 1957 and 1977 at our institution has indicated that surgical treatment yields a good long-term result. Long-term results in twenty-five patients with sufficiently long follow-up (average, sixty-five months) were recorded. Ninety-two per cent of the patients had had a history of severe ankle sprain or fracture and many had had chronic symptoms before the definitive diagnosis was made. The surgical treatment consisted of drilling and curettage followed by non-weight-bearing and early range-of-motion exercises. Twenty-two patients had good or excellent results, two had fair results, and one had a poor result. In eleven patients followed for five to eighteen years, no deterioration in functional capacity was noted; however, improvement in the postoperative status was noted for as long as eighteen months. Even when it was performed for a chronic lesion the operation gave a high percentage of good results, and the long-term results did not differ appreciably from the results eighteen months postoperatively. No other reports were found concerning long-term follow-up of this lesion.
1957年至1977年间，我院对49例经手术治疗的距骨穹窿部经软骨骨折患者的治疗经验表明，手术治疗可取得良好的长期效果。记录了25例随访时间足够长（平均65个月）患者的长期治疗结果。92%的患者有严重踝关节扭伤或骨折史，许多患者在确诊前就有慢性症状。手术治疗包括钻孔和刮除，随后进行不负重和早期活动度练习。22例患者效果良好或极佳，2例效果尚可，1例效果差。对11例随访5至18年的患者，未发现功能能力恶化；然而，术后状态的改善可持续长达18个月。即使对慢性病变进行手术，良好效果的比例也很高，长期结果与术后18个月的结果相比无明显差异。未发现有关该病变长期随访的其他报告。
