Conesa Xavier, Barro Víctor, Barastegui David, Batalla Lledó, Tomás Jordi, Molero Vicente
Department of Orthopedics and Traumatology, Hospital Municipal de Badalona, Barcelona, Spain.
J Foot Ankle Surg. 2011 Sep-Oct;50(5):612-5. doi: 10.1053/j.jfas.2011.04.034. Epub 2011 May 31.
Subtalar dislocation is an uncommon injury that affects the talocalcaneal and talonavicular joints, with the tibiotalar and calcaneocuboid joints remaining intact. The 4 types of subtalar dislocation are medial, lateral, anterior, and posterior, although the latter 2 are rare. These injuries-especially lateral dislocation-occur as a result of high-energy trauma. Medial dislocation is the most common type, and lateral dislocation is associated with osteochondral fractures of the talus and calcaneus, as well as with open injuries; hence, its worse prognosis. We report the case of a 62-year-old woman diagnosed with lateral subtalar dislocation accompanied by an ipsilateral bimalleolar fracture after a fall downstairs. She underwent emergency reduction of the dislocation under sedation. Surgical treatment of the bimalleolar fracture was delayed 9 days to avoid cutaneous complications. This is the first report of a subtalar dislocation accompanied by a bimalleolar fracture.
距下关节脱位是一种少见的损伤,累及距跟关节和距舟关节,而胫距关节和跟骰关节保持完整。距下关节脱位有内侧、外侧、前方和后方4种类型,不过后两种类型较为罕见。这些损伤——尤其是外侧脱位——是由高能创伤导致的。内侧脱位是最常见的类型,外侧脱位与距骨和跟骨的骨软骨骨折以及开放性损伤有关,因此其预后较差。我们报告了一例62岁女性患者的病例,该患者在从楼梯上摔下后被诊断为外侧距下关节脱位并伴有同侧双踝骨折。她在镇静状态下接受了脱位的急诊复位。双踝骨折的手术治疗推迟了9天,以避免皮肤并发症。这是关于距下关节脱位伴有双踝骨折的首例报告。