Heylen Steven, De Baets Thierry, Verstraete Patricia
Algemeen Ziekenhuis (AZ) Turnhout, Campus Sint-Elisabeth, Turnhout, Belgium.
Acta Orthop Belg. 2011 Dec;77(6):838-42.
Total dislocation of the talus is caused by a high-energy trauma, that dislocates the talus from all its surrounding articulations. Most cases reported are open talus dislocations; closed dislocations are rarely seen. Complications include avascular necrosis, posttraumatic osteoarthritis and infection. The vascularisation of the talus is delicate and the soft tissue attachments surrounding the talus are important for the blood supply. Closed talus dislocations, closed reduction and careful surgical dissection in case of open reduction respect more soft tissue attachments and potentially reduce the incidence of avascular of necrosis. We describe the case of a 46-year old male patient who sustained a closed total dislocation of the right talus associated with small fractures of the lateral and medial malleolus. The talus could not be reduced by closed means. The malleolar fractures were treated by open reduction and internal fixation.
距骨全脱位由高能创伤引起，使距骨与其所有周围关节脱开。报告的大多数病例为开放性距骨脱位；闭合性脱位很少见。并发症包括缺血性坏死、创伤后骨关节炎和感染。距骨的血供精细，距骨周围的软组织附着对血供很重要。闭合性距骨脱位、闭合复位以及开放性复位时仔细的手术剥离能保留更多软组织附着，可能降低缺血性坏死的发生率。我们描述了一名46岁男性患者的病例，该患者发生了右距骨闭合性全脱位，并伴有内外踝小骨折。无法通过闭合方法复位距骨。踝部骨折通过切开复位内固定进行治疗。
