Neue Techniken in der operativen Versorgung von Calcaneusfrakturen

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• 作者：Prof. Dr. S. Rammelt ; M. Amlang ; A. K. Sands ; M. Swords
• 关键词：Dislocation ; Fracture fixation ; internal ; Postoperative complications ; Sustentaculum ; Anterior process
• 刊名：Der Unfallchirurg
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：119
• 期：3
• 页码：225-238
• 全文大小：1,527 KB
• 参考文献：1.Zwipp H, Rammelt S (2014) Tscherne Unfallchirurgie. Fuß. Springer-Verlag, Berlin
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• 作者单位：Prof. Dr. S. Rammelt (1)
  M. Amlang (1)
  A. K. Sands (2)
  M. Swords (3)
  
  1. UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
  2. New York Presbyterian Hospital – Lower Manhattan Hospital, New York, NY, USA
  3. Michigan Orthopedic Center, East Lansing, MI, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Traumatic Surgery
  Medicine/Public Health, general
  Sports Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-044X

文摘

The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously. A thorough knowledge of the three dimensional calcaneal anatomy and open reduction maneuvers is a prerequisite for good results with less invasive techniques. Early functional follow-up treatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.