Gantsos A, Giotis D, Giannoulis D K, Vasiliadis H S, Georgakopoulos N, Mitsionis G I
Department of Orthopaedic Surgery, University Hospital of Ioannina, Greece.
Foot (Edinb). 2013 Jun-Sep;23(2-3):107-10. doi: 10.1016/j.foot.2013.06.001. Epub 2013 Jul 27.
We report a case of a closed subtalar dislocation without any related fractures treated with closed reduction and conservative treatment with a cast immobilization. Pure subtalar dislocation without any fractures is extremely rare and hardly reported in the literature. Such injuries are more likely to be open and associated with fractures of the surrounding foot bones such as malleoli, talus or fifth metatarsal fractures. In the examined case, closed reduction was followed by cast immobilization for 3 weeks. Six months post-injury, the patient had a full range of motion without any pain while there were no signs of residual instability or early post-traumatic osteoarthritis. Subjective clinical testing using a valid health instrument revealed an excellent outcome. We discuss in details the mechanism of such an injury and highlight the importance of prompt closed reduction and early mobilization to ensure a satisfactory long term outcome.
我们报告一例闭合性距下关节脱位,无任何相关骨折,采用闭合复位及石膏固定保守治疗。单纯性距下关节脱位且无任何骨折极为罕见,文献中鲜有报道。此类损伤更易为开放性损伤,并伴有周围足部骨骼骨折,如踝关节骨折、距骨骨折或第五跖骨骨折。在所检查的病例中,闭合复位后行石膏固定3周。伤后6个月,患者活动范围正常,无任何疼痛,且无残留不稳定或创伤后早期骨关节炎的迹象。使用有效的健康评估工具进行主观临床测试显示预后极佳。我们详细讨论了此类损伤的机制,并强调了及时闭合复位和早期活动对于确保满意的长期预后的重要性。