Objective To compare the clinical efficacy of open reduction and internal fixation with or without bone graft treatment for displaced intra-articular calcaneal fractures.Methods The following electronic database was searched:PubMed,Embase and Conchrane Libray database.The time limit was from the establishing of the database to April 2017.Main evaluation index included excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,SF-36.Secondary evaluation index included incision necrosis or dehiscence,wound infection and osteoarthritis.The Review Manager 5.3 software was used for Meta-analysis.Results There were seven articles in qualitative and quantitative synthesis,two groups of a total of 824 cases,399 cases of bone graft.The Meta analysis showed that bone graft group and non bone graft group were not statistically significantly different at the end of follow-up (excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,incision necrosis or dehiscence,wound infection and osteoarthritis).There was statistically significant difference in SF-36.Conclusion According to meta analysis results,considering bone grafts leading to higher hospital costs or pain in donor site after autologous bone graft,bone graft is not essential for displaced intra-articular calcaneus fractures.

外侧踝关节扭伤(lateral ankle sprains,LASs)是最常见的运动损伤[1],约80%都能通过保守治疗康复,20%经治疗后依然发展成为慢性踝关节不稳定(chronic ankle instability, CAI).其症状包括:顽固性的疼痛、打软腿、反复扭伤和肿胀等.CAI分为功能性不稳定(functional ankle instability, FAI)和机械性不稳定(mechanical ankle instability ,MAI).前者韧带没有明显的松弛,不稳定的原因主要是踝关节受伤后该部位神经末梢和本体感觉未恢复导致的本体感觉缺失和平衡能力降低.后者为踝关节器质性病变的CAI患者,抽屉试验及应力位X线为阳性.两者之间最大的差别就是关节运动幅度是否处于正常范围,但有时较难区分且存在一定程度的共存.FAI可能发展为MAI.CAI若诊断治疗不及时可形成扭伤-不稳定-再扭伤的恶性循环,继而发生创伤性关节炎、关节软骨变性甚至永久性的功能障碍.CAI的诊断与治疗仍然具有争议性.根据国内外最新研究报道,本文对相关诊断与治疗做一综述,为临床诊治提供参考.