Fuss und Sprunggelenk最新文献

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Correction Target of Supramalleolar Osteotomy for Early Varus Ankle Arthritis: Is Overcorrection Necessary? 踝上截骨术治疗早期内翻性踝关节关节炎的矫治目标：矫治过度是否必要？

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.04.003

引用次数: 0

Minimalinvasive Frakturversorgung des Talus – wann ist sie indiziert? 骨盆的微创骨折供应-什么时候应该进行治疗？

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.05.006

Annika Steinmeier , Frank Graef , Tobias Gehlen

Talus fractures are rare and complex injuries, typically resulting from severe sprains or high-energy trauma, and can lead to significant functional impairment. The primary therapeutic objective is the precise anatomical reduction of the fracture while ensuring maximal preservation of the soft tissue structures. Currently, evidence regarding the optimal management of talus fractures remains limited. In addition to open surgical approaches, minimally invasive techniques are increasingly being recognized as a promising alternative.

This review outlines the various minimally invasive access routes for mini-open or arthroscopic treatment, highlighting their application and the advantages they offer over conventional open surgical procedures. Minimally invasive techniques offer substantial benefits in terms of preserving soft tissue integrity and the blood supply to the talus, thereby reducing the risk of complications. These approaches are particularly indicated for fractures with minimal displacement.

In contrast, severely displaced fractures are typically managed through large open approaches, but can be more effectively addressed with a tissue-preserving arthroscopic technique. Arthroscopy not only facilitates precise fracture reduction but also provides versatile treatment options for concomitant osteochondral lesions.

Thus, in the surgical management of talus fractures, soft tissue-sparing, minimally invasive approaches should be considered as a first-line option to optimize functional outcomes while minimizing the risk of complications.

距骨骨折是一种罕见且复杂的损伤，通常由严重扭伤或高能创伤引起，可导致严重的功能损伤。主要的治疗目标是在确保最大限度地保留软组织结构的同时，精确地解剖复位骨折。目前，关于距骨骨折的最佳治疗方法的证据仍然有限。除了开放手术外，微创技术越来越被认为是一种有前途的替代方法。这篇综述概述了各种微创入路，用于微型开放或关节镜治疗，强调了它们的应用和它们相对于传统开放手术的优势。微创技术在保持软组织完整性和距骨血液供应方面提供了实质性的好处，从而降低了并发症的风险。这些入路特别适用于移位最小的骨折。相比之下，严重移位骨折通常通过大的开放入路治疗，但可以更有效地通过组织保留关节镜技术治疗。关节镜检查不仅有助于精确骨折复位，而且还为伴随的骨软骨病变提供了多种治疗选择。因此，在距骨骨折的手术治疗中，应考虑保留软组织，微创入路作为一线选择，以优化功能结果，同时最大限度地减少并发症的风险。

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引用次数: 0

Minimalinvasive Versorgungstechniken von Kalkaneusfrakturen des Erwachsenen: Methoden, Ergebnisse und Perspektiven 非甾体抗炎药的临床应用：方法、结果和前景

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.05.004

I. Rinas, T. Mittlmeier, S. Märdian

Calcaneal fractures are among the most common injuries of the foot and represent a demanding challenge for the orthopaedic surgeon because of the complex anatomy of the calcaneus and its biomechanical implications. Whilst open reduction and internal fixation (ORIF) via the extended lateral approach (ELA) remained the gold standard over the last decades a high rate of postoperative soft tissue complications lead to the development of less invasive operation techniques for the treatment of calcaneal fractures like the sinus tarsi approach (STA). This article presents an overview on various minimally invasive surgical techniques and the present state-of-the-art in the most recent scientific context.

跟骨骨折是足部最常见的损伤之一，由于跟骨复杂的解剖结构及其生物力学意义，对骨科医生来说是一个艰巨的挑战。虽然通过扩展外侧入路（ELA）的切开复位内固定（ORIF）在过去几十年中仍然是金标准，但术后软组织并发症的高发率导致了微创手术技术的发展，用于治疗跟骨骨折，如跗骨窦入路（STA）。本文概述了各种微创手术技术和最新科学背景下的最新技术。

引用次数: 0

Vom Bild zur Schraube – Versorgungsansätze bei Talus- und Kalkaneusfrakturen 从植物到植物：从植物到植物的分类和分类

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.04.001

引用次数: 0

Anatomical and Micro-CT Assessment of the First Metatarsal Head Vascularization and Soft Tissue Envelope Following Minimally Invasive Chevron Osteotomy for Hallux Valgus Deformity 微创Chevron截骨术治疗拇外翻畸形后第一跖头血管和软组织包膜的解剖和显微ct评价

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.04.002

引用次数: 0

Moderne Bildgebung von Sprunggelenk und Rückfuß 现代绘画和雕塑。

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.05.001

Markus Herbert Lerchbaumer , Torsten Diekhoff

No new modalities have been introduced in multimodal musculoskeletal (MSK) imaging of the ankle in recent years, but existing imaging procedures have been optimized. Sonography is known to be the primary imaging modality for assessing tendons and ligaments in the ankle joint area, especially the Achilles tendon. As a new metric parameter, shear wave elastography has been introduced in clinical routine, primarily used in tendon characterization with regard to tendinopathies. In addition the established use of sonography in trauma imaging, research in this area is currently focusing on its use for extended quantitative diagnostics and follow-up imaging. Conventionally used tomographic imaging modalities (computed tomography [CT] and magnetic resonance imaging [MRI]) has been fundamentally improved to overcome its physical limitations. MRI optimized by artificial intelligence (AI) acceleration enables a significant reduction of scanning time regarding Turbo-spin-echo sequences and thus a reduction of the examination time to 4 to 6 min per joint, while image quality remains unchanged. This leads to considerable time savings combined with more capacity in MSK imaging with MRI. The new parametric CT algorithms (DECT and photon counting CT) enable improved assessment of bone and soft tissue as well as quantitative evaluation of bone and soft tissue changes.

近年来，踝关节多模态肌肉骨骼（MSK）成像没有引入新的模式，但现有的成像程序已经优化。超声被认为是评估踝关节区域肌腱和韧带的主要成像方式，尤其是跟腱。剪切波弹性成像作为一种新的度量参数已被引入临床常规，主要用于肌腱病变的肌腱表征。除了超声在创伤成像中的既定应用外，该领域的研究目前正侧重于其在扩展定量诊断和随访成像中的应用。传统的层析成像方式（计算机断层扫描[CT]和磁共振成像[MRI]）已经从根本上得到了改进，克服了其物理局限性。通过人工智能（AI）加速优化的MRI可以显着减少涡轮旋转回波序列的扫描时间，从而将每个关节的检查时间减少到4到6 分钟，同时图像质量保持不变。这节省了大量的时间，并增加了MRI MSK成像的容量。新的参数CT算法（DECT和光子计数CT）可以改进骨和软组织的评估以及骨和软组织变化的定量评估。

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引用次数: 0

Zugangswege zur Talusfraktur – Kann der ventrale Zugang bilaterale Zugänge ersetzen? 骨盆骨折通路-腹侧通路能取代双侧通路吗？

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.05.005

Dominik Adl Amini , Frank Graef , Tobias Gehlen

Talus fractures are among the most complex injuries in the lower extremity. Overall, they are a rare injury and account for only approx. 0.3–0.5% of all fractures and approx. 3–4% of fractures of the foot. They mainly affect young adults (third decade of life) in a ratio of 3:1 between men and women. Due to the specific anatomical, biomechanical and vascular characteristics of the talus, surgical treatment is challenging. The correct choice of the surgical approach is crucial in order to achieve anatomical reduction of the fracture and good long term function.

Traditionally, bilateral approaches are used for complex talus fractures, exposing both the the medial and lateral side of the talus. Establishing the ventral approach allows direct visualization of the caput and the colum ventrally. However, the question arises as to whether this method can represent a less invasive invasive alternative to the traditional bilateral approaches.

In summary, the evidence suggests that the ventral approach may be a useful alternative to bilateral approaches for certain indications, particularly isolated fractures of the talar neck. However, bilateral approaches remain the gold standard for complex, multidirectional fractures. The choice of the surgical approaxch should nevertheless always be individually based on fracture complexity, patient characteristics and surgical expertise.

距骨骨折是下肢最复杂的损伤之一。总的来说，它们是一种罕见的伤害，只占大约。约占所有骨折的0.3-0.5%。3-4%的足部骨折。它们主要影响年轻人（生命的第三个十年），男女比例为3:1。由于距骨特殊的解剖、生物力学和血管特征，手术治疗具有挑战性。正确选择手术入路对于实现骨折的解剖复位和良好的远期功能至关重要。传统上，双侧入路用于复杂距骨骨折，暴露距骨内侧和外侧。建立腹侧入路可以直接看到腹侧的颅底和脊柱。然而，问题是这种方法是否可以替代传统的双侧入路。总之，有证据表明腹侧入路对于某些适应症，特别是离骨颈孤立骨折，可能是双侧入路的有效替代方法。然而，双侧入路仍然是治疗复杂多向骨折的黄金标准。然而，手术入路的选择应根据骨折的复杂性、患者特征和外科专业知识而定。

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引用次数: 0

Häufig übersehene peritalare Frakturen 经常被忽视的腹股沟骨折

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/j.fuspru.2025.05.002

Ann-Sophie C. Weigel, Alexander Milstrey, Michael J. Raschke, Sabine Ochman

Peripheral talus fractures are among the rarest foot injuries (20% of all talus fractures). These fracture can lead to a reduced functional outcome and are associated with concomitant injuries such as subtalar dislocation. Furthermore, peripheral talus fractures are often diagnosed late or even overlooked, suggest ing a high number of unreported cases. This can be explained by the poor visibility of the fractures on conventional x -rays. If such x-rays do not indicate a fracture but the clinical picture does, further clarification with cross-sectional imaging, in particular computerised tomography, should be considered.

Peritalar fractures can be categorised according to the American Orthopaedic Trauma Association (OTA) or the AO classification. In contrast, fractures of the lateral talar process are categorised according to Hawkins. Subtalar dislocations are categorised according to their dislocation pattern. Depending on the fracture morphology, soft tissue damage and concomitant injuries, the further procedure (conservative or surgical treatment) is determined. The few existing studies show that the severity of the injury and the concomitant injuries have an influence on the outcome.

外周距骨骨折是最罕见的足部损伤之一（占所有距骨骨折的20%）。这些骨折可导致功能下降，并伴有距下脱位等损伤。此外，外周距骨骨折通常诊断较晚，甚至被忽视，这表明有大量未报告的病例。这可以解释为在常规x射线上骨折的能见度较差。如果这样的x光片不提示骨折，但临床表现提示骨折，则应考虑用横断面成像，特别是计算机断层扫描进一步澄清。骨盆外骨折可根据美国骨科创伤协会（OTA）或AO分类进行分类。相反，距侧突骨折根据Hawkins分类。距下脱位是根据其脱位模式分类的。根据骨折形态、软组织损伤和伴随损伤，确定进一步的治疗方法（保守或手术治疗）。现有的少数研究表明，损伤的严重程度和伴随损伤对预后有影响。

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引用次数: 0

ÖGF Termine

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/S1619-9987(25)00107-2

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Neuafnahmen (Stand 01.03.25) 检索日期：2011-03-25。

Q4 Medicine

Fuss und Sprunggelenk

Pub Date : 2025-06-01 DOI: 10.1016/S1619-9987(25)00106-0

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