Letournel E
University of Paris VI, France.
Clin Orthop Relat Res. 1993 May(290):60-7.
Displaced intraarticular fractures of the calcaneus require operative intervention to restore the anatomy of the bone, which in turn is the requirement for recovery of subtalar joint mobility. Surgery through a lateral incision, without opening the sheath of the peroneal tendons, and the use of lag screws and a "Y-plate," must restore not only the respective positions of the "three poles" of the calcaneus but also the respective orientations of the articular surfaces. Stable internal fixation allows early active and passive mobilization of the subtalar and ankle joints. If this is not achieved, the functional outcome will be poor.
跟骨移位性关节内骨折需要手术干预以恢复骨骼解剖结构，而这又是距下关节活动度恢复的必要条件。通过外侧切口进行手术，不打开腓骨肌腱鞘，并使用拉力螺钉和“Y形钢板”，不仅必须恢复跟骨“三极”的各自位置，还必须恢复关节面的各自方向。稳定的内固定可使距下关节和踝关节早期进行主动和被动活动。如果做不到这一点，功能预后将很差。
