Joshi Anil Kumar, Joshi Chitra, Singh Saurabh, Singh Vikram
Department of Orthopaedics, V.C.S.G. Government Medical Sciences and Research Institute, Srinagar, Pauri Garhwal, Uttarakhand, India.
Foot (Edinb). 2012 Dec;22(4):319-21. doi: 10.1016/j.foot.2012.08.001. Epub 2012 Sep 15.
Traumatic loss of talus during a compound injury of ankle is an unusual injury.
We report a 55 years old woman who sustained an open ankle injury with complete extrusion of talus and loss at the injury site.
A tricortical bone graft was obtained from iliac crest and talar dimensions carved with 5 cm length and 3 cm height given by buttressing fibular graft between them. These grafts are made in the shape of talus by fixing them together with cortical screw and binding them together with Ethibond No. 5. By anterior approach ankle was opened and talar graft was placed in between the raw surfaces of tibia and calcaneus to facilitate ankle arthrodesis.
Patient had solid fusion at the ankle joint after 4 months with no pain on walking.
The definitive treatment of this serious lower extremity injury remains controversial we have attempted this novel way of treatment as the patient was unable to afford talar prosthesis and facilities of allogenic bone grafts were not there.
踝关节复合伤时距骨创伤性缺失是一种不常见的损伤。
我们报告一名55岁女性，她遭受开放性踝关节损伤，距骨完全挤出且损伤部位缺失。
从髂嵴获取一块三皮质骨移植块，根据距骨尺寸雕刻，长度为5厘米，高度为3厘米，其间用支撑腓骨移植块连接。将这些移植块用皮质螺钉固定在一起，并用5号Ethibond缝线捆绑成距骨形状。通过前路切开踝关节，将距骨移植块置于胫骨和跟骨的粗糙表面之间以促进踝关节融合。
患者4个月后踝关节实现牢固融合，行走时无疼痛。
这种严重下肢损伤的确定性治疗仍存在争议。由于患者无力承担距骨假体且没有同种异体骨移植的条件，我们尝试了这种新颖的治疗方法。
