Choi Young Rak, Jeong Jae Jung, Lee Ho Seong, Kim Sang Woo, Suh Jin-Soo
Department of Orthopedic Surgery, Cha Bundang Medical Center, CHA University, Seongnam-si, Korea.
Department of Orthopedic Surgery, College of Medicine, Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Korea.
Clin Pract. 2011 Apr 11;1(1):e12. doi: 10.4081/cp.2011.e12. eCollection 2011 Mar 29.
A completely extruded talus without any remaining soft tissue attachments is extremely rare. The present report describes treatment of a 45-year-old man who sustained a completely extruded talus injury following a rock-climbing fall. Upon admission, the extruded talus was deep-frozen in our bone bank. The open ankle joint underwent massive wound debridement and irrigation for 3 days. Four days later we performed a primary subtalar fusion between the extruded talus and the calcaneus, anticipating revascularization from the calcaneus. However, aseptic loosening and osteolysis developed around the screw and talus. At 12 months post-trauma we performed a tibiocalcaneal ankle fusion with a femoral head allograft to fill the talar defect. Follow-up at 24 months post-trauma showed the patient had midfoot motion, tibio-talar-calcaneal fusion, and was able partake in 4-hour physical activity twice per week.
距骨完全脱出且无任何残留软组织附着极为罕见。本报告描述了一名45岁男性在攀岩坠落时发生距骨完全脱出损伤的治疗情况。入院时，脱出的距骨在我们的骨库中进行了深冻处理。开放性踝关节进行了为期3天的大量伤口清创和冲洗。4天后，我们对脱出的距骨和跟骨进行了一期距下关节融合术，期望通过跟骨实现再血管化。然而，螺钉和距骨周围出现了无菌性松动和骨质溶解。创伤后12个月，我们采用同种异体股骨头进行了胫跟踝关节融合术以填充距骨缺损。创伤后24个月的随访显示，患者中足有活动能力，胫距跟关节融合良好，并且能够每周进行两次每次4小时的体育活动。
