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02\u8ddf\u9aa8\u7ed3\u8282\u590d\u4f4d<\/p>\n

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\u672f\u540e\u5eb7\u590d<\/p>\n

\u4f7f\u7528\u8e1d\u5173\u8282\u5904\u4e8e\u4e2d\u6027\u80cc\u5c48\u7684\u540e\u5939\u677f2\u5468\u3002\u88ab\u52a8\u548c\u4e3b\u52a8\u6d3b\u52a8\u8303\u56f4\u4ece\u7b2c\u4e09\u5468\u5f00\u59cb\u3002\u60a3\u8005\u7a7f\u7740\u6b65\u884c\u9774\u4fdd\u6301\u975e\u8d1f\u91cd8\u5468\uff0c\u7136\u540e\u5728\u5f71\u50cf\u5b66\u8bc4\u4f30\u540e\u5f00\u59cb\u5b8c\u5168\u8d1f\u91cd(\u56fe8).\u5728\u8fd9\u4e00\u70b9\u4e0a\uff0c\u7269\u7406\u6cbb\u7597\u5c06\u96c6\u4e2d\u5728\u6e10\u8fdb\u5f3a\u5316\uff0c\u672c\u4f53\u611f\u89c9\u548c\u6b63\u5e38\u6b65\u6001\u6062\u590d\u3002\u4ece\u7b2c\u56db\u4e2a\u6708\u5f00\u59cb\uff0c\u5141\u8bb8\u6062\u590d\u4f4e\u5f3a\u5ea6\u7684\u8fd0\u52a8\uff0c\u672f\u540e6\u4e2a\u6708\u6062\u590d\u5b8c\u5168\u7684\u8fd0\u52a8\u3002<\/p>\n<\/p>\n

\u56fe8\u3002\u672f\u540e\u653e\u5c04\u7167\u7247\u3002a\u3001\u6a2a\u5411\uff1bb\uff0c\u8f74\u5411\u3002<\/p>\n

\u8ba8\u8bba<\/p>\n

\u672c\u6587\u4ecb\u7ecd\u4e86\u4e00\u79cd\u901a\u8fc7STA\u5bf9\u8ddf\u9aa8\u5173\u8282\u5185\u9aa8\u6298\u8fdb\u884c\u5185\u56fa\u5b9a\u7684\u9010\u6b65\u624b\u672f\u65b9\u6cd5\uff0c\u8fd9\u5bf9\u4e8e\u83b7\u5f97\u89e3\u5256\u590d\u4f4d\u662f\u4e00\u4e2a\u6311\u6218\u3002<\/p>\n

DIACF\u7684\u624b\u672f\u6cbb\u7597\u5df2\u88ab\u8bc1\u660e\u53ef\u4ee5\u6539\u5584\u529f\u80fd\u7ed3\u679c\uff0c\u957f\u671f\u9884\u9632\u665a\u671f\u521b\u4f24\u540e\u9aa8\u5173\u8282\u708e(OA ),\u5e76\u964d\u4f4e\u7ee7\u53d1\u6027\u878d\u5408\u7387\u3002Buckley\u548c\u52a0\u62ff\u5927\u9aa8\u79d1\u521b\u4f24\u7814\u7a76(COTS)\u5c0f\u7ec4\u8fdb\u884c\u4e86\u4e00\u9879\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c(RCT ),\u7eb3\u5165\u4e86471\u540dDIACF\u60a3\u8005\uff0c\u663e\u793a\u624b\u672f\u6cbb\u7597\u6bd4\u975e\u624b\u672f\u6cbb\u7597\u6709\u66f4\u597d\u7684\u7ed3\u679c\u3002COTS\u7ec4\u8fd8\u786e\u5b9a\u4e86\u4e0e\u521b\u4f24\u6027\u5173\u8282\u708e\u548c\u4e8c\u6b21\u8ddd\u4e0b\u878d\u5408\u76f8\u5173\u7684\u98ce\u9669\u56e0\u7d20\u3002Bolher\u89d2\u51cf\u5c0f\u7684\u60a3\u8005\u9700\u8981\u884c2\u6b21\u5173\u8282\u878d\u5408\u53ef\u80fd\u6027\u63d0\u9ad810\u500d\u3002Sanders IV\u578b\u9aa8\u6298\u9700\u8981\u878d\u5408\u7684\u53ef\u80fd\u6027\u589e\u52a0\u4e865.5\u500d\u3002\u540c\u6837\uff0cgren\u7b49\u4eba\u5bf976\u540dDIACF\u60a3\u8005\u8fdb\u884c\u4e86RCT\u3002\u57288-12\u5e74\u7684\u968f\u8bbf\u4e2d\uff0c\u4ed6\u4eec\u663e\u793a\u4e86\u624b\u672f\u7ec4\u66f4\u597d\u7684\u529f\u80fd\u7ed3\u679c\u548c\u66f4\u4f4e\u7684\u521b\u4f24\u540eOA\u60a3\u75c5\u7387\u3002\u66f4\u91cd\u8981\u7684\u662f\uff0c\u53d1\u73b0Bolher\u89d2\u548c\u5173\u8282\u9762\u4fee\u590d\u4e0e\u8f83\u597d\u7684\u7ed3\u679c\u76f8\u5173\u3002\u7ed3\u5408\u6765\u81ea\u4e0d\u540c\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u8bc1\u636e\uff0c\u4e5f\u663e\u793a\u4e86\u624b\u672f\u6cbb\u7597\u5bf9\u53d1\u751f\u521b\u4f24\u540e\u9aa8\u5173\u8282\u708e\u7684\u957f\u671f\u76ca\u5904\u548c\u7ee7\u53d1\u6027\u8ddd\u4e0b\u878d\u5408\u7684\u5fc5\u8981\u6027\u3002\u6b64\u5916\uff0c\u4e0e\u521d\u59cb\u975e\u624b\u672f\u6cbb\u7597\u76f8\u6bd4\uff0c\u521d\u59cbORIF\u4e0e\u75c7\u72b6\u6027\u8ddd\u4e0bOA\u8ddd\u4e0b\u878d\u5408\u540e\u66f4\u597d\u7684\u529f\u80fd\u7ed3\u679c\u76f8\u5173\u3002\u56e0\u6b64\uff0c\u9002\u5f53\u51cf\u5c11DIACF\u4e0d\u4ec5\u5bf9\u786e\u4fdd\u6539\u5584\u77ed\u671f\u529f\u80fd\u7ed3\u679c\u5f88\u91cd\u8981\uff0c\u800c\u4e14\u5bf9\u957f\u671f\u7ed3\u679c\u4e5f\u5f88\u91cd\u8981\uff0c\u8fd9\u5bf9\u5927\u591a\u6570\u60a3\u8005\u6765\u8bf4\u53ef\u80fd\u4f1a\u6539\u53d8\u751f\u6d3b\u3002<\/p>\n

\u53e6\u4e00\u65b9\u9762\uff0c\u8ddf\u9aa8\u9aa8\u6298\u7684\u624b\u672f\u6cbb\u7597\u53ef\u80fd\u4ee5\u591a\u79cd\u5e76\u53d1\u75c7\u4e3a\u4ee3\u4ef7\uff0c\u8fd9\u53ef\u80fd\u63a5\u8fd120%\u300221\u8fd9\u4e9b\u5305\u62ec\u611f\u67d3\u3001\u76ae\u74e3\u574f\u6b7b\u3001\u795e\u7ecf\u8840\u7ba1\u635f\u4f24\u3001\u590d\u4f4d\u4e0d\u826f\u3001\u690d\u5165\u7269\u76f8\u5173\u95ee\u9898\u548c\u9aa8\u4e0d\u8fde\u3002\u867d\u7136STA\u786e\u5b9e\u4f1a\u51fa\u73b0\u8fd9\u4e9b\u5e76\u53d1\u75c7\uff0c\u4f46\u5927\u591a\u6570\u90fd\u662f\u5728ELA\u4e2d\u51fa\u73b0\u7684\u3002\u8fd9\u90e8\u5206\u662f\u7531\u4e8e\u4e0eSTA\u76f8\u6bd4\uff0cELA\u4e0a\u5199\u7684\u6587\u732e\u6570\u91cf\u66f4\u591a\uff0cSTA\u53ea\u662f\u5728\u6700\u8fd1\u624d\u83b7\u5f97\u66f4\u5e7f\u6cdb\u7684\u4f7f\u7528\u3002\u56e0\u6b64\uff0c\u5728\u6cbb\u7597DIACF\u7684\u51b3\u7b56\u8fc7\u7a0b\u4e2d\uff0c\u75c5\u4eba\u7684\u9009\u62e9\u548c\u624b\u672f\u7684\u65f6\u673a\u662f\u81f3\u5173\u91cd\u8981\u7684\u3002<\/p>\n

DIACF\u7684\u6700\u4f73\u6cbb\u7597\u65b9\u6848\u4ecd\u6709\u4e89\u8bae\u3002\u7ecfSTA\u5207\u5f00\u590d\u4f4d\u5185\u56fa\u5b9a\u6cbb\u7597\u8ddf\u9aa8\u9aa8\u6298\u56e0\u5176\u5b89\u5168\u6027\u9010\u6e10\u53d7\u5230\u91cd\u89c6\u3002\u6700\u8fd1\u7684\u8bc1\u636e\u6bd4\u8f83\u4e86\u975e\u624b\u672f\u548c\u624b\u672f\u6cbb\u7597\uff0c\u5305\u62ec\u6807\u51c6ELA\u548cSTA\uff0c\u8003\u8651\u5230\u826f\u597d\u7684\u5f71\u50cf\u5b66\u7ed3\u679c\u548c\u8f83\u4f4e\u7684\u5207\u53e3\u76f8\u5173\u5e76\u53d1\u75c7\uff0c\u652f\u6301\u5fae\u521b\u65b9\u6cd5\u3002\u7279\u522b\u662f\uff0c\u63a5\u53d7STA\u7684\u60a3\u8005\u8868\u73b0\u51fa96.4%\u7684\u6ee1\u610f\u7387\u3002STA\u5df2\u88ab\u8bc1\u660e\u5bf9\u4e8eDIACF\u7684\u51cf\u5c11\u662f\u53ef\u9760\u7684\uff0c\u56e0\u4e3a\u5728Sanders II\u578b\u548cIV\u578b\u4e2d\uff0cELA\u548cSTA\u4e4b\u95f4\u7684\u5c04\u7ebf\u7167\u76f8\u51cf\u5c11\u662f\u76f8\u4f3c\u7684\u3002\u56e0\u6b64\uff0c\u5728DIACF\u7684\u5916\u79d1\u6cbb\u7597\u4e2d\uff0c\u901a\u8fc7STA\u7684ORIF\u53ef\u80fd\u662f\u4e00\u4e2a\u66f4\u5b89\u5168\u7684\u9009\u62e9\u3002\u672c\u6587\u5f3a\u8c03\u4e86\u91cd\u8981\u7684\u6b65\u9aa4\u53ca\u624b\u672f\u6280\u672f\uff0c\u5f53\u4f7f\u7528STA\u6cbb\u7597DIACF\u65f6\uff0c\u9075\u5faa\u8fd9\u4e9b\u6b65\u9aa4\u53ef\u4ee5\u4f7f\u624b\u672f\u8fc7\u7a0b\u987a\u5229\uff0c\u5e76\u51cf\u5c11\u672f\u540e\u5e76\u53d1\u75c7\u3002<\/p>\n

\u7ed3\u8bba<\/p>\n

\u590d\u6742\u8ddf\u9aa8\u9aa8\u6298\u7684\u89e3\u5256\u590d\u4f4d\u53ef\u4ee5\u901a\u8fc7\u4f7f\u7528STA\u7684\u9010\u6b65\u65b9\u6cd5\u5b9e\u73b0\u3002\u6309\u987a\u5e8f\u9075\u5faa\u56fe\u793a\u6b65\u9aa4\u53ef\u4ee5\u4f7f\u590d\u4f4d\u66f4\u5bb9\u6613\uff0c\u76ee\u7684\u662f\u89e3\u5256\u590d\u4f4d\u548c\u66f4\u597d\u7684\u529f\u80fd\u7ed3\u679c\u3002<\/p>\n

\u53c2\u8003\u6587\u732e<\/p>\n

1.\u00c5gren PH, Wretenberg P, Sayed-Noor AS. Operative versus nonoperative treatment of displaced intra-articular calcaneal fractures. A prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2013;95(15):1351-1357.<\/p>\n

2.\u00c5gren PH, Mukka S, Tullberg T, Wretenberg P, Sayed-Noor AS. Factors affecting long-term treatment results of displaced intraarticular calcaneal fractures: a post hoc analysis of a prospective, randomized, controlled multicenter trial. J Orthop Trauma. 2014;28(10):564-568.<\/p>\n

3.Berberian W, Sood A, Karanfilian B, Najarian R, Lin S, Liporace F. Displacement of the sustentacular fragment in intra-articular calcaneal fractures. J Bone Joint Surg Am. 2013;95(11):995-1000.<\/p>\n

4.Bruce J, Sutherland A. Surgical versus conservative interventions for displaced intra-articular calcaneal fractures. Cochrane Database Syst Rev. 2013;(1):CD008628.<\/p>\n

5.Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures. A prospective, randomized, controlled multicenter trial. J Bone Joint Surg Am. 2002;84(10):1733-1744.<\/p>\n

6.Busel G, Mir HR, Merimee S, et al. Quality of reduction of displaced intra-articular calcaneal fractures using a sinus tarsi versus extensile lateral approach. J Orthop Trauma. 2021;35(6):285-288.<\/p>\n

7.Ceccarini P, Manfreda F, Petruccelli R, Talesa G, Rinonapoli G, Caraffa A. Minimally invasive sinus tarsi approach in sanders II-III calcaneal fractures in high-demand patients. Med Glas. 2021;18(1):1-6.<\/p>\n

8. Csizy M, Buckley RE, Tough S, et al. Displaced intra-articular calcaneal fractures: variables predicting late subtalar fusion. J Orthop Trauma. 2003;17(2):106-112.<\/p>\n

9.Dickenson EJ, Parsons N, Griffin DR. Open reduction and internal fixation versus nonoperative treatment for closed, displaced, intra-articular fractures of the calcaneus: long-term follow-up from the HeFT randomized controlled trial. Bone Joint J. 2021;103-B(6):1040-1046.<\/p>\n

10.Griffin D, Parsons N, Shaw E, et al; UK Heel Fracture Trial Investigators. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ. 2014;349(July):1-13.<\/p>\n

11.Khazen G, Rassi CK. Sinus tarsi approach for calcaneal fractures: the new gold standard? Foot Ankle Clin. 2020;25(4):667-681.1<\/p>\n

12.Lin J, Xie C, Chen K, et al. Comparison of sinus tarsi approach versus extensile lateral approach for displaced intra-articular calcaneal fractures Sanders type IV. Int Orthop. 2019;43(9):2141-2149.<\/p>\n

13.Liu GT, Vanpelt MD, Lalli T, Raspovic KM, Wukich DK. Surgical management of displaced intra-articular calcaneal fractures: what matters most? Clin Podiatr Med Surg. 2019;36(2):173-184.<\/p>\n

14.Park CH, Yoon DH. Role of subtalar arthroscopy in operative treatment of Sanders type 2 calcaneal fractures using a sinus tarsi approach. Foot Ankle Int. 2018;39(4):443-449.<\/p>\n

15.Radnay CS, Clare MP, Sanders RW. Subtalar fusion after displaced intra-articular calcaneal fractures: does initial operative treatment matter? J Bone Joint Surg Am. 2009;91(3):541-546.<\/p>\n

16.Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures: results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;290:87-95.<\/p>\n

17.Schepers T. Fixation by open reduction and internal fixation or primary arthrodesis of calcaneus fractures: indications and technique. Foot Ankle Clin. 2020;25(4):683-695.<\/p>\n

18.Shi FL, Wu SY, Cai W, Zhao YM. Comparison of 5 treatment approaches for displaced intra-articular calcaneal fractures: a systematic review and bayesian network meta-analysis. J Foot Ankle Surg. 2020;59(6):1254-1264.<\/p>\n

19.van der Vliet QMJ, Lucas RC, Velmahos G, et al. Foot fractures in polytrauma patients: injury characteristics and timing of diagnosis. Injury. 2018;49(6):1233-1237.<\/p>\n

20.Wang CS, Tzeng YH, Yang TC, Lin CC, Chang MC, Chiang CC. Radiographic and clinical results of modified 2-incision sinus tarsi approach for treatment of calcaneus fracture. Injury. 2021;52(7):1971-1977.<\/p>\n

21.Wei N, Zhou Y, Chang W, Zhang Y, Chen W. Displaced intra-articular calcaneal fractures: classification and treatment. Orthopedics. 2017;40(6):e921-e929.<\/p>\n

\u58f0\u660e\uff1a\u672c\u6587\u4ec5\u4f9b\u533b\u5b66\u4e13\u4e1a\u4eba\u58eb\u9605\u8bfb\u53c2\u8003\uff0c\u4e0d\u4ee3\u8868\u9aa8\u4eca\u4e2d\u5916\u5e73\u53f0\u89c2\u70b9\uff0c\u5e0c\u671b\u5927\u5bb6\u7406\u6027\u5224\u65ad\uff0c\u6709\u9488\u5bf9\u6027\u5730\u5e94\u7528\u3002<\/p>\n