Progress in the treatment of malunion of calcaneal fractures
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.
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