Monroe M T, Manoli A
Department of Orthopaedic Surgery, University of South Alabama, Mobile, USA.
Foot Ankle Int. 1999 Mar;20(3):192-5. doi: 10.1177/107110079902000310.
A malunion of the talar neck after a Hawkins type II fracture/dislocation of the talar neck occurred in a 34-year-old man after nonoperative treatment. Rigid varus deformity of the forefoot was a source of severe pain and disability in this patient. We describe our surgical technique for osteotomy of the talar neck with insertion of a tricortical iliac crest bone graft to correct the deformity. At follow-up (56 months), the patient had consistent relief of pain and was employed at his preinjury job doing heavy labor. The score on the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale improved from 11 points, preoperatively, to 85 points, postoperatively. Radiographs showed maintenance in the position of the osteotomy and no evidence of avascular necrosis in the talar body. Evidence of arthrosis of the talonavicular joint was apparent radiographically, but the patient did not complain of symptoms referable to this area.
一名34岁男性在接受非手术治疗后，距骨颈霍金斯II型骨折/脱位后出现了距骨颈畸形愈合。前足严重内翻畸形是该患者严重疼痛和残疾的根源。我们描述了一种距骨颈截骨术的手术技术，同时植入三面皮质髂嵴骨移植来纠正畸形。随访（56个月）时，患者疼痛持续缓解，并恢复了受伤前从事重体力劳动的工作。美国矫形足踝协会踝-后足评分从术前的11分提高到术后的85分。X线片显示截骨位置保持良好，距骨体无缺血性坏死迹象。距舟关节的关节病在X线片上明显可见，但患者并未主诉该区域的症状。
