von Knoch F, Reckord U, von Knoch M, Sommer C
Department of Orthopaedic Surgery Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland.
J Bone Joint Surg Br. 2007 Jun;89(6):772-7. doi: 10.1302/0301-620X.89B6.18813.
We investigated the clinical and radiological outcome after unilateral fracture of the lateral process of the talus in 23 snowboarders with a mean follow-up of 3.5 years (12 to 76 months). In this consecutive cohort study both operative and non-operative cases were considered. The mean American Orthopaedic Foot and Ankle Society hindfoot score was 94 (82 to 100). The non-operative group of seven with a minimally-displaced fracture scored higher (98 points) than the operative group of 16 with displaced or unstable fractures (93 points). In 88% of operative cases, significant concomitant hindfoot injuries were found at operation. All but eight (35%) patients (six operative and two non-operative) regained their pre-injury level of sporting activity. Subtalar osteoarthritis was present in nine (45%) of the 20 patients available for radiological review, including one late-diagnosed non-operative case and eight operative cases with associated injuries or fracture comminution. The outcome after fracture of the lateral process of the talus in snowboarders is favourable provided an early diagnosis is made and adequate treatment, which is related to the degree of displacement and associated injuries, is undertaken.
我们对23名单侧距骨外侧突骨折的单板滑雪运动员进行了临床和影像学随访,平均随访时间为3.5年(12至76个月)。在这项连续性队列研究中,纳入了手术治疗和非手术治疗的病例。美国矫形足踝协会后足评分平均为94分(82至100分)。7例骨折移位极小的非手术治疗组患者评分更高(98分),而16例骨折移位或不稳定的手术治疗组患者评分为93分。在88%的手术病例中,术中发现有明显的合并后足损伤。除8例(35%)患者(6例手术治疗和2例非手术治疗)外,其余所有患者均恢复到受伤前的运动水平。在可供影像学检查的20例患者中,9例(45%)出现距下骨关节炎,其中包括1例诊断较晚的非手术治疗病例和8例伴有相关损伤或骨折粉碎的手术治疗病例。对于单板滑雪运动员距骨外侧突骨折,只要能早期诊断并根据骨折移位程度和合并损伤进行适当治疗,其预后是良好的。