Bulut G, Colak I, Mik G, Kilic Z, Tasdemir Z
Department of Orthopaedics, Dr Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
Department of Orthopaedics, Istanbul Surgery Hospital, Istanbul, Turkey.
Malays Orthop J. 2018 Jul;12(2):47-51. doi: 10.5704/MOJ.1807.009.
An 18-year old male patient, with a history of paragliding accident, sustaining a coronal shear fracture of the body of the talus, an anterior process fracture of the calcaneus extending to the calcaneocuboid joint and a nondisplaced navicular body fracture at the right foot and a displaced fracture of the navicular body accompanied with posteromedial process fracture of the talus at the left side was referred to our emergency clinic. For the right foot, the coronal plane fracture of the talar body was anatomically reduced and fixed with screws. For the left foot, screw fixation was performed through the lateral aspect to fix the large posteromedial fragment. Small bone fragments were removed from the left navicular fracture, and the main fragments were also fixed with screw. The talo-navicular joint was stabilised with a Kirschner wire. At 36 months follow-up, bilateral foot and ankle functions were satisfactory, Maryland scores of the right and left foot were 85 (good) and 90 (excellent), respectively, and the patient regained his full activity level by the 5th month postoperatively. With reference to the number and types of fractures in this one patient, we present a standard protocol for treatment of isolated talus, navicular and calcaneal fractures presenting together in a single foot injury.
一名18岁男性患者，有滑翔伞事故史，右足距骨体冠状面剪力骨折、跟骨前突骨折延伸至跟骰关节、舟骨体无移位骨折，左侧舟骨体移位骨折并伴有距骨后内侧突骨折，被转诊至我院急诊。对于右足，距骨体冠状面骨折进行解剖复位并用螺钉固定。对于左足，通过外侧进行螺钉固定以固定较大的后内侧骨折块。从左舟骨骨折处取出小骨块，主要骨折块也用螺钉固定。用克氏针稳定距舟关节。随访36个月时，双足踝关节功能良好，右足和左足的马里兰评分分别为85分（良好）和90分（优秀），患者术后第5个月恢复了全部活动水平。参照该例患者骨折的数量和类型，我们提出了一种针对单足损伤中同时出现的孤立性距骨、舟骨和跟骨骨折的标准治疗方案。
