Huang Peng-Ju, Cheng Yuh-Min
Orthopaedic Department of Kaohsiung, Medical University Hospital, Kaohsiung, Taiwan.
Int Orthop. 2005 Oct;29(5):326-9. doi: 10.1007/s00264-005-0675-1. Epub 2005 Aug 11.
From 1993 to 2002, we treated nine patients for neglected or mal-reduced talar fractures. Average patient age was 39 (20-64) years and average follow-up 53 months. The time interval between injury and index operation ranged from 4 weeks to 4 years. Surgical procedures included open reduction with or without bone grafting in six cases, open reduction combined with ankle fusion in one case, talar neck osteotomy in one case, and talar neck osteotomy combined with subtalar fusion in one case. All cases had solid bone union. One patient developed avascular necrosis of the talus needing subsequent ankle arthrodesis. In six patients, adjacent hindfoot arthrosis occurred. The overall AOFAS ankle-hindfoot score was in average 77.4. We conclude that in neglected and mal-reduced talar fractures, surgical treatment can lead to a favourable outcome if the hindfoot joints are not arthritic.
1993年至2002年，我们治疗了9例被忽视或复位不良的距骨骨折患者。患者平均年龄为39岁（20 - 64岁），平均随访时间为53个月。受伤至初次手术的时间间隔为4周 至4年。手术方式包括6例行切开复位，其中2例同时植骨，1例行切开复位联合踝关节融合术，1例行距骨颈截骨术，1例行距骨颈截骨术联合距下关节融合术。所有病例均实现了牢固的骨愈合。1例患者发生距骨缺血性坏死，随后需要进行踝关节融合术。6例患者出现相邻后足关节病。美国足与踝关节协会（AOFAS）踝关节 - 后足评分平均为77.4分。我们得出结论，对于被忽视和复位不良的距骨骨折，如果后足关节没有关节炎，手术治疗可取得良好的效果。
