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距下关节闭合性脱位合并距骨和舟骨无移位骨折:1例病例报告及文献复习

Closed subtalar dislocation with non-displaced fractures of talus and navicular: a case report and review of the literature.

作者信息

Fotiadis Elias, Lyrtzis Christos, Svarnas Theodoros, Koimtzis Miltos, Akritopoulou Kiriaki, Chalidis Byron

机构信息

Orthopaedic Department, General Hospital of Veria, Veria, 59100, Greece.

出版信息

Cases J. 2009 Sep 1;2:8793. doi: 10.4076/1757-1626-2-8793.

Abstract

Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 ;weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was in normal limits and the patient could still work as a builder. However, he complained for occasionally mild pain due to the development of post-traumatic arthritis in subtalar and ankle joints. Our search in literature revealed that conservative treatment of all the successfully reduced and minimally displaced subtalar fracture-dislocations has given superior results compared to surgical management. However, even in cases with no or slight fracture displacement, avascular necrosis of the talus or arthritis of the surrounding joints can compromise the final functional outcome.

摘要

合并距骨和舟骨骨折的闭合性距下关节脱位是罕见的损伤。我们报告一例43岁男性建筑工人,发生内侧距下关节脱位,并伴有轻微移位的距骨和舟骨骨折。在全身麻醉下成功进行闭合复位,随后非负重,并使用膝下石膏固定踝关节6周。伤后3年,距下关节稳定,足踝活动度正常,患者仍能从事建筑工作。然而,他抱怨距下关节和踝关节创伤后关节炎偶尔引起轻度疼痛。我们对文献的检索显示,与手术治疗相比,对所有成功复位且移位轻微的距下骨折脱位进行保守治疗效果更佳。然而,即使在骨折无移位或轻微移位的情况下,距骨缺血性坏死或周围关节的关节炎也可能影响最终的功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea6f/2769472/257bf2507878/1757-1626-0002-0000008793-001.jpg

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