Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
J Bone Joint Surg Am. 2010 Apr;92(4):890-4. doi: 10.2106/JBJS.I.00490.
Little attention has been devoted to subtalar dislocations without an associated bone injury in the literature to date. The aim of this study was to assess the functional and subjective results of a cohort of patients with this injury.
A total of ninety-seven patients with a subtalar dislocation were treated at two major university trauma centers from January 1994 to March 2007. Computed tomographic scans indicated a subtalar dislocation without associated bone injury in twenty-three of these patients. Clinical and radiographic examinations were performed on all twenty-three patients at an average of 58.3 months after the completion of treatment. The postoperative clinical examination was supplemented by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, and the degree of arthritis was assessed radiographically.
The average score on the AOFAS ankle-hindfoot scale score was 82.3 points. Twenty-one patients achieved a good result, and two patients had a satisfactory result. The range of motion of the subtalar joint was an average of 41.3 degrees. No difference between the results of the medial and lateral subtalar dislocations was observed. Only six patients had minor radiographic changes.
The intermediate-term results for a subtalar dislocation without an associated osseous injury are good, and the direction of the dislocation does not appear to make a difference with regard to clinical or radiographic outcome.
迄今为止，文献中几乎没有关注无伴发骨损伤的距下关节脱位。本研究旨在评估一组此类损伤患者的功能和主观结果。
1994 年 1 月至 2007 年 3 月，两个主要的大学创伤中心共治疗了 97 例距下关节脱位患者。其中 23 例患者的计算机断层扫描（CT）显示距下关节脱位而无伴发骨损伤。所有 23 例患者在治疗完成后平均 58.3 个月时进行了临床和影像学检查。术后临床检查补充了美国矫形足踝协会（AOFAS）踝关节后足评分，并且通过影像学评估关节炎的程度。
AOFAS 踝关节后足评分的平均得分为 82.3 分。21 例患者获得良好的结果，2 例患者获得满意的结果。距下关节的活动范围平均为 41.3 度。未观察到内侧和外侧距下关节脱位结果之间的差异。只有 6 例患者有轻微的影像学改变。
无伴发骨损伤的距下关节脱位的中期结果良好，且脱位的方向在临床或影像学结果方面似乎没有差异。
