Napiontek Marek, Pietrzak Krzysztof
Ortop Poliklinika, Poznań.
Chir Narzadow Ruchu Ortop Pol. 2009 Sep-Oct;74(5):309-13.
Fracture of the talus, especially talar neck associated with talar dome necrosis, due to serious disorders of the ankle and subtalar joints. Disorders are so great that they often suggest to perform arthrodesis of the ankle joint. Disorders of subtalar joint are not so much visible on standard X-rays. Results of triple arthodesis performed in 3 patients (3 feet) because of talar fracture sequele were reported. In 1 femal talar fracture was combined with calcaneal fracture in the same foot. Age at trauma ranged from 22 do 31 years (mean 27). Indications for secondary operative treatment were mainly clinical criterias as subtalar pain and in 1 male additionaly varus deformity of the foot. Feet were stabilized by K wires going both through Chopart and ankle joints. Follow-up ranged from 35 to 50 months. Functional results in modyfied AOFAS scale ranged from 43 to 81 points (mean 65) of 94. Subjective results ranged from 7 to 10 points (mean 8) of 10. At follow-up examination no one reported restricted range of motion in the ankle joint in comparison to pre operation as well no any progression of osteoarthritis was visible on x-rays.
距骨骨折，尤其是伴有距骨穹窿坏死的距骨颈骨折，是由于踝关节和距下关节的严重紊乱所致。这些紊乱非常严重，常常提示需要进行踝关节融合术。距下关节的紊乱在标准X射线上不太明显。报告了3例（3只脚）因距骨骨折后遗症而进行三关节融合术的结果。在1例女性中，距骨骨折与同一只脚的跟骨骨折合并。受伤年龄在22岁至31岁之间（平均27岁）。二次手术治疗的指征主要是临床标准，如距下疼痛，在1例男性中还伴有足部内翻畸形。通过穿过Chopart关节和踝关节的克氏针来稳定足部。随访时间为35至50个月。根据改良的美国足踝外科协会（AOFAS）评分，功能结果在94分中为43至81分（平均65分）。主观结果在10分中为7至10分（平均8分）。在随访检查中，与术前相比，没有人报告踝关节活动范围受限，X射线上也没有可见骨关节炎的进展。
