跟骨骨折

Fractures of the calcaneus

跟骨骨折是最常见的跗骨骨折,多因从高处跌下所致。其合适的骨折分型、治疗选择、手术指征、手术入路和术后处理仍存在争议。跟骨骨折分为关节外骨折和关节内骨折。Sanders的分型方法对跟骨骨折治疗方法的选择及预后的判断有重要意义。跟骨骨折的治疗具有挑战性,目前尚无理想的治疗方法,有待于进一步深入研究。保守治疗适合于移位小的骨折,对于移位大或粉碎的骨折可应用手术治疗。跟骨骨折的并发症有张力性水疱,筋膜间隙综合征,伤口裂开,伤口感染,疼痛,距跟关节炎等。本文对跟骨骨折的损伤机制、分型、评分、治疗方法及并发症等作一综述。

Fractures of the calcaneus are the most common of tarsal bon e fractures and usually the result of a fall from a great height. Controversies remain regarding the appropriate classification system, treatment options, indic ations for surgery, surgical approaches and postoperative management. The calcan eal fractures are divided into extra-articular fractures and intra-articular f ractures. Sanders Classification is of great importance to the treatment options and the outcome assessments. The treatment of the calcaneal fractures is challe nging, but the ideal treatment for the calcaneal fractures has not been found so that further research is needed. Nonoperative treatment continues to be the pre ferred method for non-displaced fractures. Displaced and comminuted fractures c an be treated with operation. Complications after calcaneal fractures include bl isters, compartment syndrome, wound dehiscence, wound infection, pain, subtalar arthritis and so on. This article reviews the injury mechanism, classification, score, treatment and complication of the calcaneal fractures.