Kadakia Anish P, Sarkar Jay
Trauma and Orthopaedics, Luton and Dunstable Hospital NHS Trust, Luton, United Kingdom.
J Foot Ankle Surg. 2007 Nov-Dec;46(6):488-92. doi: 10.1053/j.jfas.2007.06.005. Epub 2007 Sep 6.
Osteochondritis dissecans can affect any joint, although the ankle is the third most common location after the knee and elbow. When the ankle is involved, the lesion usually affects the talar dome. The authors report a case of osteochondritis of the subtalar joint affecting the talus in a 14-year-old girl without any history of trauma. Plain radiographs did not show any bony pathology, and the diagnosis was made with computerized tomography. The patient was treated initially in a non-weight bearing plaster cast with antiinflammatory medication and subsequent physiotherapy. The conservative treatment failed to relieve her symptoms, and she underwent subtalar arthroscopy followed by surgical excision, curettage, and drilling through a mini-arthrotomy. Postoperatively, the patient was managed with protected weight bearing and physiotherapy. A year after surgery, she had returned to her routine activities, including sports, with no further complaints related to the affected foot.
剥脱性骨软骨炎可累及任何关节,不过踝关节是继膝关节和肘关节之后第三大常见发病部位。当累及踝关节时,病损通常影响距骨穹窿。作者报告了一例14岁女孩距下关节剥脱性骨软骨炎累及距骨的病例,该女孩无任何外伤史。X线平片未显示任何骨质病变,诊断通过计算机断层扫描作出。患者最初采用非负重石膏固定并给予抗炎药物治疗,随后进行物理治疗。保守治疗未能缓解其症状,于是她接受了距下关节镜检查,随后通过小切口进行手术切除、刮除和钻孔。术后,患者接受了保护性负重和物理治疗。术后一年,她已恢复日常活动,包括运动,患足未再出现任何不适。