Almasi J, Csonge L, Galambos B
Petz Aladár County Teaching Hospital Gyor Traumatology, Orthopaedics and Hand Surgery Centre, Gyor, Hungary.
Bratisl Lek Listy. 2011;112(5):290-1.
A case of a young female patient is presented who underwent a tibiocalcaneal arthodesis for infected necrosis of the talus after total talus extrusion. We report our surgical technique of tibiocalcaneal arthrodesis as a salvage procedure for this complex problem. It was performed in two stages. Total talectomy and implantation of antibiotic spacer was followed by tibiocalcaneal fusion using a blade plate. The bone loss was compensated with autodigested, antigen extracted allogeneic bone.
Total extrusion of the talus is a rare and severe injury of the foot. The outcome is unpredictable and the presence of infection and bone loss is a challenge for the surgeon to achieve a successful outcome.
Union was defined both clinically and radiographically. The clinical outcomes were mesured using a AOFAS hindfoot score. The radiographic healing was determined by the presence of trabeculation across the arthrodesis.
The time of follow up was 18 months and the fusion was achieved after 8 months.
The presented technique for tibiocalcaneal arthrodesis is an option for the treatment of these serious lower extremity injuries and chemosterilized, antigen-extracted autolyzed allograft is appropriate for the reconstructive procedures of the foot and ankle (Fig. 2, Ref. 6).
本文介绍了一例年轻女性患者，该患者因距骨完全脱位后发生感染性距骨坏死而接受了胫跟关节融合术。我们报告了胫跟关节融合术的手术技术，作为解决这一复杂问题的挽救手术。该手术分两个阶段进行。首先进行距骨全切并植入抗生素间隔物，然后使用接骨板进行胫跟融合。骨缺损用自消化、抗原提取的同种异体骨进行补偿。
距骨完全脱位是一种罕见且严重的足部损伤。其预后不可预测，感染和骨缺损的存在对外科医生来说是实现成功治疗结果的一大挑战。
通过临床和影像学检查来确定融合情况。临床结果采用美国足踝外科协会（AOFAS）后足评分进行评估。影像学愈合通过关节融合处出现骨小梁来确定。
随访时间为18个月，8个月后实现了融合。
本文介绍的胫跟关节融合术技术是治疗这些严重下肢损伤的一种选择，化学消毒、抗原提取的自溶同种异体骨适用于足踝部的重建手术（图2，参考文献6）。
