Chan Gar Ming, Yoshida Douglas
Department of Emergency Medicine, Bellevue Hospital Center, New York University School of Medicine, New York, NY 10016, USA.
Ann Emerg Med. 2003 Jun;41(6):854-8. doi: 10.1067/mem.2003.213.
Snowboarding is one of the fastest-growing winter sports and is associated with a relatively high rate of ankle injuries. Presented is a patient who, after falling while snowboarding, complained of lateral ankle pain and was misdiagnosed with an ankle sprain. Further workup revealed a lateral process of the talus fracture, an injury that is rare outside of snowboarding. A lateral process of the talus fracture should be suspected when there is a history of inversion with dorsiflexion and there is tenderness over the lateral process of the talus. Results of plain films are negative up to 40% of the time, and therefore a computed tomographic scan is the imaging modality of choice. Treatment includes immobilization and not bearing weight for 4 to 6 weeks for nondisplaced fractures or open reduction and fixation for displaced fractures. Up to two thirds of patients with lateral process of the talus fractures report chronic pain. Early recognition may decrease this relatively high rate of morbidity.
单板滑雪是发展最快的冬季运动项目之一,且与较高的踝关节损伤发生率相关。本文介绍了一名患者,他在单板滑雪时摔倒后,抱怨踝关节外侧疼痛,最初被误诊为踝关节扭伤。进一步检查发现为距骨外侧突骨折,这种损伤在单板滑雪以外的情况中很少见。当有背屈内翻病史且距骨外侧突有压痛时,应怀疑距骨外侧突骨折。平片检查结果在高达40%的情况下为阴性,因此计算机断层扫描是首选的成像方式。治疗方法包括:对于无移位骨折,固定4至6周且不负重;对于移位骨折,则进行切开复位内固定。高达三分之二的距骨外侧突骨折患者报告有慢性疼痛。早期识别可能会降低这种相对较高的发病率。