Burdeaux B D
Baylor College of Medicine, Houston, Texas.
Clin Orthop Relat Res. 1993 May(290):96-107.
A practical classification of calcaneus fractures based on standard heel roentgenograms and Brodén's views is presented. Diagnosis is made from these roentgenograms, even though many believe that more sophisticated studies are needed. In fact, only the Brodén's and lateral views are needed for diagnosis. What one needs to know is the type of fracture present, whether it is a tongue or joint depression-type fracture, and the width of the fragment. The necessary information is easily determined from these roentgenograms. Once these facts are known, a plan of approach can be made. The medial approach is an indirect method of reduction as one might use for the tibia or femur fracture. Experience has shown that the longitudinal threaded pin is an excellent method of stabilization. It is quick and effective. It has eliminated the need for exposure of the neurovascular bundle. Minimal metal is implanted, and a smaller incision is used. Most common calcaneal fractures can be reduced well from the medial side. A few may need lateral reduction also, but this is simplified if the nonarticular components of the fracture are reduced first by the medial approach technique. The results of the medial approach technique have been much better in the last 12 years. This is attributed to the classification, the knowledgeable interpretation of the roentgenograms, and use of the threaded longitudinal pin for fixation.
本文提出了一种基于标准足跟X线片和布罗登位片的跟骨骨折实用分类方法。尽管许多人认为需要更复杂的检查来诊断，但仅通过这些X线片就能做出诊断。实际上，诊断仅需要布罗登位片和侧位片。需要了解的是骨折的类型，是舌形骨折还是关节塌陷型骨折，以及骨折块的宽度。这些必要信息很容易从这些X线片中确定。一旦了解了这些情况，就可以制定治疗方案。内侧入路是一种间接复位方法，类似于用于胫骨或股骨骨折的方法。经验表明，纵向螺纹针是一种很好的固定方法。它快速有效。它无需暴露神经血管束。植入的金属最少，切口也较小。大多数常见的跟骨骨折可以从内侧很好地复位。少数骨折可能也需要外侧复位，但如果先通过内侧入路技术复位骨折的非关节部分，外侧复位就会简化。在过去12年中，内侧入路技术的效果要好得多。这归因于分类方法、对X线片的专业解读以及使用螺纹纵向针进行固定。
