Andersen Robert C, Neiderer Katherine, Martin Billy, Dancho James
Southern Arizona VA Health Care System, Tucson, AZ 85723, USA.
J Am Podiatr Med Assoc. 2013 May-Jun;103(3):246-9. doi: 10.7547/1030246.
Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture.
舟状骨体部骨折相对少见。迄今为止,很少有文献讨论舟状骨体部骨折合并第一和第二楔骨在舟状骨上背侧半脱位的情况。本病例报告介绍了一名患有这种损伤的30岁患者。他成功接受了舟状骨体部骨折的切开复位内固定术,但在韧带重建后,舟楔关节未能充分复位。翻修手术后,他也未能通过克氏针经皮固定6周。在比较类似损伤(Lisfranc骨折脱位)的文献时,相同的原则可能适用。对于舟状骨体部骨折后舟楔关节脱位,应考虑采用坚强的切开复位内固定术,甚至一期融合术进行治疗。