Cianforlini Marco, Marinelli Mario, Ponzio Isabella, de Palma Luigi
Clinical Orthopaedics, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
Clinical Orthopaedics, School of Medicine, Università Politecnica delle Marche, Ancona, Italy.
J Surg Case Rep. 2014 Feb 18;2014(2). doi: 10.1093/jscr/rju007. Print 2014 Feb.
We present a 49-year-old man with a traumatic subamputation of the forefoot, associated with lacerated wound in correspondence of the dorsal surface of the right foot, with injuries of tendinous, ligamentous and vascular structures and with the loss of talus head. The patient underwent salvage arthrodesis of the talonavicular and calcanealcuboid joints with graft bone harvested from the iliac crest. The patient was re-evaluated during a clinical and radiographic follow-up. The arthrodesis was consolidated in ∼3 months. There were no infectious problems and the patient has resumed normal work activities. At a sixth month follow-up, the patient had returned to work and remained pain free while walking. Early anatomic reduction, stable fixation and ligament reconstruction are essential for a good outcome. Primary arthrodesis is a viable option for severe midfoot fracture dislocations, because it facilitates rehabilitation and functional recovery and obviates the need for a secondary arthrodesis should arthritis arise.
我们报告一名49岁男性，其前足遭受创伤性次全离断，右足背侧相应部位有撕裂伤，伴有肌腱、韧带和血管结构损伤以及距骨头缺失。患者接受了距舟和跟骰关节的挽救性关节融合术，取自髂嵴的植骨用于手术。在临床和影像学随访期间对患者进行了重新评估。关节融合术在约3个月时愈合。未出现感染问题，患者已恢复正常工作活动。在6个月的随访中，患者已重返工作岗位，行走时无疼痛。早期解剖复位、稳定固定和韧带重建对于良好的预后至关重要。对于严重的中足骨折脱位，一期关节融合术是一种可行的选择，因为它有助于康复和功能恢复，并且如果出现关节炎，无需进行二期关节融合术。
