Yvars M F
Clin Orthop Relat Res. 1976 Jan-Feb(114):185-91.
Fractures of the talor dome are uncommon and may elude diagnosis despite routine roentgenograms of injured ankles. Tomograms are helpful in localizing this lesion. Surgical removal of the osteochondral fragment is often indicated. Medial lesions may be inaccessible except by osteotomy of the medial malleolus which is then fixed with a bone screw. Lateral fragments are approached through anterolateral or posterolateral ankle incisions. Of 9 symptomatic ankles, 6 had satisfactory results following surgery. The other 3 were treated conservatively, one improved; two did not. One additional asymptomatic ankle remained so with no treatment. In one case the talus also contained an unusual cystic lesion; in another there was tarsal coalition.
距骨穹窿骨折并不常见，尽管对受伤的踝关节进行了常规X线检查，仍可能漏诊。断层扫描有助于确定该病变的位置。通常需要手术切除骨软骨碎片。内侧病变可能难以触及，除非通过内踝截骨术，然后用骨螺钉固定。外侧碎片可通过踝关节前外侧或后外侧切口进行处理。9例有症状的踝关节中，6例术后效果满意。另外3例采用保守治疗，1例有所改善；2例没有改善。另有1例无症状的踝关节未经治疗仍无症状。1例患者的距骨还存在一个不寻常的囊性病变；另1例存在跗骨联合。
