骨科英文书籍精读（392）｜跟骨骨折的并发症
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Complications
EARLY
Swelling and blistering
Intense swelling and blistering may jeopardize operative treatment. The limb should be elevated with the minimum of delay.
Compartment syndrome
About 10 per cent of patients develop intense pressure symptoms. The risk of a fullblown compartment syndrome can be minimized by starting treatment early. If operative decompression is carried out, this will delay any definitive procedure for the fracture.
LATE
Malunion
Closed treatment of displaced fractures, or injudicious weightbearing after open reduction, may result in malunion. The heel is broad and squat, and the patient has a problem fitting shoes. Usually the foot is in valgus and walking may be impaired.
Peroneal tendon impingement
Lateral displacement of the body of the calcaneum may cause painful compression of the peroneal tendons against the lateral malleolus. Treatment consists of operative paring down of protuberant bone on the lateral wall of the calcaneum.
Insufficiency of the tendo Achillis
The loss of heel height may result in diminished tendo Achillis action. If this interferes markedly with walking, subtalar arthrodesis with insertion of a bone block may alleviate the problem.
Talocalcaneal stiffness and osteoarthritis
Displaced intraarticular fractures may lead to joint stiffness and, eventually, osteoarthritis. This can usually be managed conservatively but persistent or severe pain may necessitate subtalar arthrodesis. If the calcaneocuboid joint is also involved, a triple arthrodesis is better.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
jeopardize /ˈdʒepərdaɪz/vt. 危害；使陷危地；使受危困
Intense swelling and blistering may jeopardize operative treatment.严重肿胀和起水泡可能危及手术治疗。
injudicious/ˌɪndʒuˈdɪʃəs/adj. 不明智的；不慎重的；浅薄的；不聪明的
Peroneal tendon impingement 腓骨肌腱撞击
/,perə'ni:əl/adj. 腓骨的；腓侧的
/im'pindʒmənt/n. 冲击；影响；侵犯
protuberant /proʊˈtuːbərənt/adj. 突起的；招人注意的；显著的
subtalar arthrodesis距下关节融合
Talocalcaneal距跟的
This can usually be managed conservatively but persistent or severe pain may necessitate subtalar arthrodesis.
这通常可以保守治疗，但持续或严重的疼痛可能需要距下关节融合术。
calcaneocuboid joint跟骰关节
DeepL翻译（仅供参考，建议自己翻译）：
并发症
早期
肿胀和水疱
强烈的肿胀和水泡可能会影响手术治疗。肢体应被抬高，尽量避免延误。
隔离室综合征
大约10%的病人会出现强烈的压力症状。通过尽早开始治疗，可以将全面的室间隔综合征的风险降到最低。如果进行手术减压，这将推迟任何明确的骨折手术。
晚期
融合不良
对移位的骨折进行封闭式治疗，或在开放性减压后不慎负重，可能会导致骨愈合不良。脚跟宽大而下蹲，病人穿鞋有困难。通常足部处于外翻状态，行走可能受到影响。
腓肠肌腱压迫症
小腿骨体的侧向移位可能导致腓肠肌腱压迫外侧小腿骨而产生疼痛。治疗方法包括手术削去小腿骨外侧壁上的突起的骨头。
跟腱发育不全
脚跟高度的丧失可能导致跟腱作用的减弱。如果这对行走有明显的影响，插入骨块的胫骨关节置换术可以缓解这一问题。
踝关节僵硬和骨关节炎
移位的关节内骨折可能导致关节僵硬，最终导致骨关节炎。这通常可以通过保守治疗来解决，但持续的或严重的疼痛可能需要进行跖骨关节置换术。如果小腿骨关节也受累，则最好采用三联式关节置换术。