Crosswell Sebastien, Rhee Shin-Jae, Wagner Wolfgang W
Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, Shropshire, UK
Department of Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK.
J Surg Case Rep. 2014 Oct 15;2014(10):rju100. doi: 10.1093/jscr/rju100.
Talar compression fractures are uncommon orthopaedic injuries, especially in the immature skeleton. Fractures of the talar body constitute >5% of all foot and ankle fractures. The combination of a medial compression fracture and corresponding medial malleolar fracture is rare and not previously reported injury in the literature. We present a case report of a skeletally immature 15-year-old Caucasian male who sustained a medial malleolar and corresponding medial talus fracture after being ejected from his pushbike. This report outlines the potential difficulties in diagnosing an unusual fracture combination and the importance of initial management including necessary diagnostic imaging to identify such injuries. Through this case, we aim to highlight the need for having high suspicions of underlying fractures in paediatric trauma cases. The long-term complications and risks of osteonecrosis of the talus can have detrimental effect on a patient's outcome; therefore, we also emphasize the need for regular monitoring and long-term follow-up.
距骨压缩骨折是一种少见的骨科损伤，在未成熟骨骼中尤为罕见。距骨体骨折占所有足踝部骨折的比例超过5%。内侧压缩骨折合并相应内踝骨折的情况较为罕见，此前文献中未见相关报道。我们报告一例病例，一名15岁骨骼未成熟的白种男性，从自行车上摔下后导致内踝及相应距骨内侧骨折。本报告概述了诊断这种不寻常骨折组合的潜在困难，以及初始处理（包括必要的诊断性影像学检查以识别此类损伤）的重要性。通过该病例，我们旨在强调在儿童创伤病例中对潜在骨折保持高度怀疑的必要性。距骨坏死的长期并发症和风险会对患者的预后产生不利影响；因此，我们还强调了定期监测和长期随访的必要性。
