Müller F, Zellner M, Füchtmeier B
Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049 Regensburg, Germany.
Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049 Regensburg, Germany.
Foot Ankle Surg. 2015 Jun;21(2):e45-7. doi: 10.1016/j.fas.2015.01.012. Epub 2015 Feb 7.
We describe a case of isolated destructive talar tuberculosis that is, to the best of our knowledge, the first reported case in Germany. Caseous talar necrosis was finally detected after repeated surgical debridements of an infection eight months after subtalar screw arthrodesis. Following the diagnosis of TB, we performed a total of three additional surgical revisions within a three-month period; these revisions included a talectomy and an induction of a septic tibiocalcaneal arthrodesis with an external fixator that was removed after solid fusion six months later. Following this treatment regime, which included pharmaceutical anti-tuberculosis therapy, the 50-year-old male patient was fitted with orthopaedic shoes. He resumed work as a professional farmer with a number of restrictions 12 months after the diagnosis and treatment of destructive talar tuberculosis.
我们描述了一例孤立性破坏性距骨结核病例，据我们所知，这是德国首例报告病例。距下关节螺钉融合术后8个月，在对感染灶进行反复手术清创后，最终检测到干酪样距骨坏死。确诊为结核病后，我们在三个月内又进行了三次手术翻修；这些翻修包括距骨切除术以及通过外固定器诱导形成感染性胫跟关节融合术，6个月后在牢固融合后拆除外固定器。在包括抗结核药物治疗的这种治疗方案之后，这位50岁的男性患者穿上了矫形鞋。在破坏性距骨结核诊断和治疗12个月后，他恢复了工作，成为一名有诸多限制的职业农民。
