Halwai Manzoor Ahmed, Mir Bashir Ahmed, Dhar Shabir Ahmed, Dar Tahir Ahmed, Butt Mohammed Farooq
The Government Hospital for Bone and Joint Surgery, Barzullah, Srinagar, Kashmir, India.
J Foot Ankle Surg. 2011 Jul-Aug;50(4):490-3. doi: 10.1053/j.jfas.2009.02.016. Epub 2011 Mar 11.
Tuberculosis of the talus is a rare condition, and the diagnosis can be difficult to make because of inconclusive laboratory and ancillary testing. In such cases, accurate diagnosis and appropriate treatment may require the use of a transmalleolar osteotomy to gain access to the involved portion of the talar body. In the case described in this article, a transmalleolar approach was used to gain access to a lytic lesion of the talar body so as to obtain microbiological and histopathological specimens for diagnostic purposes, and to thoroughly debride the lesion. After 6 years of postsurgical follow-up, the patient was leading a normal life with a full range of ankle and subtalar motion. The rarity of the diagnosis, and the use of the transmalleolar approach to a lytic and likely infected lesion in the body of the talus, makes this case worthy of public discussion.
距骨结核是一种罕见病症，由于实验室检查和辅助检查结果不明确，诊断可能会很困难。在这种情况下，准确诊断和恰当治疗可能需要采用经踝关节截骨术来显露距骨体的受累部分。在本文所述病例中，采用经踝关节入路来显露距骨体的溶骨性病变，以获取用于诊断目的的微生物学和组织病理学标本，并彻底清创病变。术后随访6年，患者踝关节和距下关节活动范围正常，生活正常。该诊断的罕见性，以及对距骨体溶骨性且可能感染病变采用经踝关节入路，使得此病例值得公开讨论。
