Conceitos atuais em fraturas intra-articulares do calcâneo

Resumo

As fraturas intra-articulares do calcâneo são lesões significativas do sistema locomotor, muitas vezes levando a deficiências permanentes na mecânica do pé, com repercussões ocupacionais, sociais e financeiras importantes. A primeira técnica de diagnóstico por imagem é a radiografia; no entanto, a tomografia computadorizada é crucial para entender a anatomia tridimensional da fratura e facilitar o planejamento cirúrgico.

O tratamento de fraturas intra-articulares do calcâneo ainda é debatido, e a literatura apoia diversas abordagens para tipos de fraturas semelhantes. Hoje, o padrão-ouro para o tratamento de fraturas da articulação subtalar é a intervenção cirúrgica. Entre as duas técnicas mais comuns, a abordagem lateral estendida e a abordagem do seio do tarso produzem desfechos funcionais comparáveis, embora a última esteja associada a menos complicações.

Este artigo discute o diagnóstico, a classificação e o tratamento das fraturas intra-articulares do calcâneo, com foco nas abordagens do seio do tarso e do “L” lateral estendido, bem como as técnicas de fixação aplicáveis a cada tipo de fratura.

Abstract

Intra-articular calcaneal fractures are significant injuries to the locomotor system, often leading to lifelong impairments in foot mechanics with substantial occupational, social, and financial repercussions. The initial imaging diagnosis relies on radiography; however, computed tomography is crucial for understanding the three-dimensional anatomy of the fracture and facilitating surgical planning.

The treatment of intra-articular calcaneal fractures remains a subject of debate, with literature supporting diverse approaches for similar fracture types. Currently, the gold standard for managing subtalar joint fractures is surgical intervention. Among the two most common techniques, the extended lateral and the sinus tarsi approaches yield comparable functional outcomes, though the latter is associated with fewer complications.

The present article discusses the diagnosis, classification, and treatment of intra-articular calcaneal fractures, focusing on the sinus tarsi and extended lateral “L” approaches, as well as the fixation techniques applicable to each fracture type.

Palavras-chave

articulação talocalcânea - calcâneo - fixação interna de fraturas - fraturas intra-articulares - fraturas ósseas - ossos do tarso

Keywords

calcaneus - fracture fixation, internal - fractures, bone - intra-articular fractures - subtalar joint - tarsal bones

Publication History

Received: 15 December 2024

Accepted: 13 March 2025

Article published online:
29 July 2025

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