de Palma Luigi, Santucci Attilio, Marinelli Mario
Cattedra di Ortopedia e Traumatologia, Universitá Politecnica delle Marche, Via Conca, Torrette, Ancona, 60100, Italy.
Foot Ankle Int. 2008 May;29(5):523-6. doi: 10.3113/fai.2008.0523.
Subtalar dislocations are uncommon and account for approximately 1% of all dislocations. Optimal management is by immediate closed reduction under general anesthesia. We report 3 cases of irreducible, isolated subtalar dislocation that required an open procedure. Closed reduction failed in 2 patients with lateral dislocation due to interposition of the posterior tibialis tendon caused by a large tear of the flexor retinaculum. The flexor retinaculum was accurately reconstructed after the reduction. In the third case, a medial dislocation, a displaced extensor retinaculum prevented relocation of the talar head and required resection. We also discuss the mechanisms for irreducible subtalar dislocations.
距下关节脱位并不常见，约占所有脱位的1%。最佳治疗方法是在全身麻醉下立即进行闭合复位。我们报告3例不可复位的孤立性距下关节脱位病例，这些病例需要进行切开手术。2例外侧脱位患者因屈肌支持带大撕裂导致胫后肌腱嵌入，闭合复位失败。复位后准确重建了屈肌支持带。在第3例内侧脱位病例中，移位的伸肌支持带阻碍了距骨头复位，需要进行切除。我们还讨论了不可复位距下关节脱位的机制。
