Department of Orthopaedics and Rehabilitation, Pennsylvania State University College of Medicine, Penn State Milton S. Hershey Medical Center, Mail Code EC089, 30 Hope Drive, Building A, Hershey, PA 17033, USA.
Foot Ankle Surg. 2010 Dec;16(4):e96-9. doi: 10.1016/j.fas.2010.02.002. Epub 2010 Mar 5.
The identification of the correct orientation of an osteochondral fragment can be challenging. Orthopaedists have been able to take advantage of advanced imaging techniques to provide guidance to the appropriate surgical intervention. Many advancements have been made in imaging modalities specific to articular cartilage [Fischbach F, Bruhn H, Unterhauser F, Ricke J, Wieners G, Felix R, et al. Magnetic resonance imaging of hyaline cartilage defects at 1.5T and 3.0T: comparison of medium T2-weighted fast spin echo, T1-weighted two-dimensional and three-dimensional gradient echo pulse sequences. Acta Radiol 2005;46(1):67-73 [Erratum in: Acta Radiol 2005;46(April (2)):218]] Furthermore, with the increasing use of bioabsorbable fixation pins, it is imperative that careful attention is paid to the correct orientation of the fragment that is to be fixed. Without awareness of the orientation, it is possible that the 180° displaced fragment could potentially be fixed in this position. At the time of this report, the patient in this case was 6 weeks postoperative and reported 0/10 pain with full painless range of motion without instability. Our goal with this case report is to promote awareness among orthopaedists and radiologists alike regarding the importance of recognizing the orientation of an osteochondral fragment and/or defect of the talus. The patient was informed that data concerning the case would be submitted for publication, and he consented.
准确识别骨软骨碎片的方向可能具有挑战性。矫形外科医生已经能够利用先进的成像技术为适当的手术干预提供指导。在关节软骨的成像方式方面已经取得了许多进展[Fischbach F, Bruhn H, Unterhauser F, Ricke J, Wieners G, Felix R, et al. 1.5T 和 3.0T 下透明软骨缺损的磁共振成像：中等 T2 加权快速自旋回波、T1 加权二维和三维梯度回波脉冲序列的比较。 Acta Radiol 2005;46(1):67-73 [勘误表：Acta Radiol 2005;46(April (2)):218]]。此外，随着可吸收固定钉的使用越来越多，必须注意正确固定要固定的碎片的方向。如果不了解方向，则可能会将 180°移位的碎片固定在该位置。在本报告所述病例中，患者在术后 6 周时报告疼痛为 0/10，无痛活动范围完全，无不稳定。我们报告这个病例的目的是提高矫形外科医生和放射科医生对认识骨软骨碎片和/或距骨缺损方向的重要性的认识。已告知患者有关该病例的数据将提交发表，并且他同意。
