Myerson M S
Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland, USA.
Orthop Clin North Am. 1995 Apr;26(2):215-27.
Comminuted fractures of the calcaneus are extremely difficult to manage, and the prognosis after this type of injury is particularly poor. The author has approached this problem with precise and anatomic restoration of the height and width of the calcaneus with open reduction and internal fixation followed by primary subtalar arthrodesis. The surgical technique of primary arthrodesis is complex and is described in detail. The rate of arthrodesis and return of function is surprisingly good given the magnitude of comminution present and has given us renewed hope that these injuries should not be abandoned to later salvage attempts at reconstruction.
跟骨粉碎性骨折极难处理，此类损伤后的预后尤其不佳。作者采用切开复位内固定精确解剖复位跟骨的高度和宽度，随后进行一期距下关节融合术来解决这一问题。一期关节融合术的手术技术复杂，将进行详细描述。鉴于存在的粉碎程度，关节融合率和功能恢复情况出奇地好，这让我们重新燃起希望，即对于这些损伤不应放弃，留待后期进行挽救性重建尝试。
