Schepers Tim, De Rooij Philippe P, Van Lieshout Esther M M, Patka Peter
Department of Surgery-Traumatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Foot Ankle Surg. 2011 Jul-Aug;50(4):486-9. doi: 10.1053/j.jfas.2011.04.003. Epub 2011 May 14.
Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral OLT results from a hypersupination trauma, in which the talar dome is caught behind the fibula. Apparently, if the forces are large enough a "flip of the coin" phenomenon occurs, causing the fragment to invert 180° upside down. We present the case of a young female patient with an inverted OLT that was treated with open reduction and internal fixation using bioabsorbable pins. Follow-up radiographs and computed tomography showed a congruent joint and complete healing of the osteochondral fragment. At the short-term follow-up visit, the functional outcome was promising.
距骨骨软骨损伤（OLTs）发病率较低，在初次就诊时高达67%的病例会被漏诊。已发表的研究中报道的距骨骨软骨损伤可能超过1500例，其中迄今为止仅有5例为倒置的前外侧距骨骨软骨损伤。前外侧距骨骨软骨损伤由过度旋后创伤引起，即距骨穹窿卡在腓骨后方。显然，如果外力足够大，就会出现“硬币翻转”现象，导致骨块倒置180°。我们报告了一例年轻女性倒置距骨骨软骨损伤患者的病例，该患者接受了切开复位并用生物可吸收钉内固定治疗。随访X线片和计算机断层扫描显示关节面平整，骨软骨碎片完全愈合。在短期随访时，功能预后良好。
