跟骨骨折畸形愈合的治疗进展  

Progress in the treatment of malunion of calcaneal fractures

作　　者：鹿亮 罗文强 李宁[1] 俞光荣[2] LU Liang;LUO Wen-qiang;LI Ning;YU Guang-rong(The First Affiliated Hospital,University of Science and Technology of China,Hefei 230001,China;Tongji Hospital,Tongji University,Shanghai 200333,China)

机构地区：[1]中国科学技术大学附属第一医院,安徽合肥230001 [2]同济大学附属同济医院,上海200333

出　　处：《实用医院临床杂志》2024年第3期10-13,共4页Practical Journal of Clinical Medicine

基　　金：国家重点研发计划项目,中部地区社区科学健身综合应用示范项目(编号:2022YFC2010200)。

摘　　要：跟骨骨折的保守治疗和手术治疗后均可能出现跟骨骨折畸形愈合。骨折位移通常导致跟骨高度丧失、足跟内翻、跟骨结节增粗、关节面台阶,可能引起前踝撞击、腓骨下撞击、腓骨肌腱刺激、创伤后关节炎。对于有症状的跟骨畸形患者,需要进行系统性评估以确定疼痛的来源。非手术治疗如活动调整、康复锻炼、矫形鞋和疼痛注射等有一定的疗效。对于严重跟骨畸形的患者,手术治疗可能更常见,手术方式包括各类截骨术、距跟关节融合术、撑开植骨术、环形外架分期手术等。具体手术方案的选择需根据跟骨畸形的具体机制、一般情况以及预期目标来选择。Both conservative and surgical treatments for calcaneal fractures may result in malunion.Fracture displacement usually leads to loss of calcaneal height,hell inversion,thickening of the calcaneal tubercle and irregularities in the joint surface.This may potentially cause the anterior ankle impingement,subfibular impingement,stimulation of the peroneal tendon and post-traumatic arthritis.In patients with symptomatic calcaneal malunion,a systematic evaluation is required to determine the source of pain.Non-surgical interventions such as activity modification,rehabilitation exercises,orthopedic footwear and pain injections have certain curative effects.For severe cases of calcaneal malunion,surgical treatment is more common.Surgical methods include various types of osteotomy,talocalcaneal joint fusion,distraction bone grafting and circular external frame staged surgery.The selection of a specific surgical approach should be based on the underlying mechanisms of calcaneal malunion,the patient's general condition,and the expected goal.

关 键 词：跟骨 骨折畸形愈合 截骨 关节融合 

分 类 号：R683.42[医药卫生—骨科学]