跟骨骨折畸形愈合的治疗研究现状  

Current research status of treatment for malunion of calcaneal fractures

作　　者：刘雪松 刘颖[2] LIU Xuesong;LIU Ying(Department of Ankle Surgery,Binzhou Medical University Yantai Affiliated Hospital,Yantai,Shandong 264199,China;Department of Ankle Surgery,Binzhou Medical University Affiliated Hospital,Binzhou,Shandong 256600,China)

机构地区：[1]滨州医学院烟台附属医院足踝外科,山东烟台264199 [2]滨州医学院附属医院足踝外科,山东滨州256600

出　　处：《医药前沿》2023年第19期26-31,共6页Journal of Frontiers of Medicine

摘　　要：发生跟骨骨折的患者无论是采用保守治疗还是手术治疗,跟骨骨折畸形愈合的可能性都很高。跟骨骨折畸形愈合通常导致跟骨高度丢失、足内外翻畸形、跟骨外侧壁增宽,可能同时伴有跟腓撞击和腓骨肌腱、腓肠神经刺激。关节面的不完整会导致距下和跟骨创伤性关节炎。对于有疼痛症状的跟骨骨折畸形愈合的患者,需要系统的评估确定疼痛的来源。非手术治疗,如活动康复、支具、矫形器和注射药物,对许多患者有效。手术治疗包括简单的跟骨外侧壁截骨术及其他类型截骨术,此外还包括距下关节融合术、三关节融合术等关节融合术,手术治疗患者满意度较非手术治疗高。当前微创手术、计算机辅助技术、3D打印技术的应用使跟骨骨折畸形愈合的治疗取得重大进展。本文对跟骨骨折畸形愈合的治疗研究进展做一综述,旨在帮助医生选择最合适的术式。The possibility of malunion of calcaneal fracture is high in patients with calcaneal fracture,whether they are treated with conservative management or surgery.The malunion of calcaneal fracture usually leads to the loss of calcaneal height,foot valgus deformity,and widening of the lateral wall of the calcaneus,which may be accompanied by heel fibula collision and stimulation of peroneal tendon and sural nerve.Incomplete joint surfaces can lead to traumatic arthritis in the subtalar and calcaneal regions.For patients with painful symptoms of malunion of calcaneal fractures,a systematic assessment is needed to determine the source of pain.Non surgical treatments,such as rehabilitation,braces,orthotics,and injectable medications,are effective for many patients.Surgical treatment includes simple lateral calcaneal wall osteotomy and other types of osteotomy,as well as subtalar joint fusion,three joint fusion,and other joint fusion surgeries.Surgical treatment has a higher patient satisfaction than non-surgical treatment.At present,the application of Minimally invasive procedure,computer Assistive technology and 3D printing technology has made great progress in the treatment of malunion of calcaneal fractures.This article provides a review of the research progress in the treatment of malunion of calcaneal fractures,with the aim of helping doctors choose the most suitable surgical method.

关 键 词：跟骨骨折 畸形愈合 研究进展 

分 类 号：R683[医药卫生—骨科学]