Borowsky K A
Department of Orthopaedics, University of the Witwatersrand, Johannesburg, South Africa.
Foot Ankle Int. 1996 Apr;17(4):210-6. doi: 10.1177/107110079601700405.
In attempted open reduction and internal fixation of displaced calcaneal fractures, comminution of the sustentacular fragment can pose major problems. Two cases of a form of external fixation are presented. The method takes advantage of the strong superomedial and plantar calcaneonavicular ligaments, which link the sustentaculum to the navicular. Traction along these structures (by pins placed in the first metatarsal) indirectly controls the sustentacular fragment, while countertraction from medially placed pins in the tuberosity allows derotation of the fragment and correct repositioning in relation to the sustentaculum. The essential deformities of a calcaneal fracture are corrected by this technique. In addition, distortion of the middle facet appears to correct as well.
在尝试对移位的跟骨骨折进行切开复位内固定时，载距突骨折块的粉碎可能会带来重大问题。本文介绍了两例采用某种外固定方式的病例。该方法利用了强大的跟舟内侧和足底韧带，这些韧带将载距突与舟骨相连。沿着这些结构进行牵引（通过将钢针插入第一跖骨）可间接控制载距突骨折块，而从内侧置于结节处的钢针进行对抗牵引则可使骨折块旋转并相对于载距突正确复位。通过该技术可纠正跟骨骨折的基本畸形。此外，中间关节面的变形似乎也能得到纠正。
