Surgical Management of Calcaneal Malunion

Calcaneal malunion is a common complication after conservative treatment or incorrect surgical treatment of calcaneal fracture. The typical pathoanatomies of calcaneal malunion are subtalar joint incongruity, loss of calcaneal height, arch collapse, varus or valgus deformity of the calcaneus, heel widening and so on. Calcaneal malunion often needs to be treated surgically. The classification of calcaneal malunion and the detailed clinical and radiographical assessment play important roles for surgical option. The main surgical methods include in situ subtalar arthrodesis, reconstruction of calcaneal thalamus and subtalar arthrodesis, calcaneal osteotomy with subtalar arthrodesis, corrective calcaneal osteotomy without subtalar arthrodesis. Each option has its different indications, advantages and disadvantages. Thus, the surgical treatment should be individualised.

中文摘要跟骨骨折畸形癒合是跟骨骨折保守治療或不正確的手術治療之後常見的併發症。常會出現距下關節面不平整，跟骨高度丟失，足弓塌陷，跟骨內外翻，跟骨增寬等典型的病理變化。跟骨骨折畸形癒合往往需要手術治療，畸形癒合的分型和詳細的臨床及影像學評估,在手術方法的選擇上起著重要作用。常見的手术方法主要有距下關節原位融合術，跟骨丘部重建距下關節融合術，跟骨截骨矯形距下關節融合術，保留距下關節的截骨矯形術等。它們各自具有不同的手術適應征及優缺點，需要根據患者的情況進行個體化選擇。