Ruatti Sébastien, Corbet Clémentine, Boudissa Mehdi, Kerschbaumer Gael, Milaire Michel, Merloz Philippe, Tonetti Jérôme
Orthopaedic Surgeon, Department of Orthopaedic and Traumatologic Surgery, Michallon Hospital, Grenoble University Hospital, Grenoble, France.
Resident, Department of Orthopaedic and Traumatologic Surgery, Michallon Hospital, Grenoble University Hospital, Grenoble, France.
J Foot Ankle Surg. 2017 Jul-Aug;56(4):905-909. doi: 10.1053/j.jfas.2017.04.005.
Dislocation of the talus is a serious and extremely rare injury, with 86 cases reported in the published data in 20 years. The reference standard for case management involves replacement of the dislocated talus to restore the height and function of the tibiotalar joint. The risk of avascular necrosis remains very high, and the standard treatment in such cases is tibiotalar arthrodesis. We report the case of total dislocation of the talus, which was treated with the insertion of a custom total talar prosthesis affixed directly to the tibial cartilage at 6 months after injury. At the 2-year follow-up point, the preliminary results were rather encouraging, with well-functioning activity and an improved American Orthopaedic Foot and Ankle Society foot function scale score increasing from 11 to 77 of 100 and a Short-Form 36-item Health Survey score increasing from 17 to 82. Much longer follow-up periods are necessary to evaluate longer term trends.
距骨脱位是一种严重且极为罕见的损伤，20年间发表的数据中报告了86例病例。病例管理的参考标准包括复位脱位的距骨以恢复胫距关节的高度和功能。缺血性坏死的风险仍然很高，此类病例的标准治疗方法是胫距关节融合术。我们报告了一例距骨完全脱位的病例，在受伤6个月后通过植入定制的全距骨假体直接固定于胫骨软骨进行治疗。在2年随访时，初步结果相当令人鼓舞，活动功能良好，美国矫形足踝协会足部功能量表评分从11分提高到100分中的77分，36项简短健康调查评分从17分提高到82分。需要更长的随访期来评估长期趋势。
