Kumar Arvind, Gaba Sahil, Digge Vijay Kumar, Gautam Deepak
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
J Clin Orthop Trauma. 2020 May-Jun;11(3):474-478. doi: 10.1016/j.jcot.2018.12.011. Epub 2018 Dec 30.
Talonavicular dislocation is a rare injury. It usually occurs in conjunction with a variety of midfoot and hindfoot injuries. Isolated medial or lateral talonavicular dislocations without disruption of subtalar joint are known as medial or lateral swivel dislocations respectively, both being extremely rare. We describe a case of neglected medial swivel dislocation with articular impaction injury of talar head, which was managed with open reduction and arthrodesis with two 4 mm cannulated cancellous screws. At 6 months follow-up, patient was pain free and walking full weight bearing. All movements were painless and there was no footwear related problems. Radiographs showed sound arthrodesis of talonavicular joint. Although a rare injury, good results can be obtained by prompt recognition and treatment. In neglected cases, arthrodesis of the talonavicular joint is a viable option, especially if articular injury is present.
距舟关节脱位是一种罕见的损伤。它通常与多种中足和后足损伤同时发生。孤立的内侧或外侧距舟关节脱位且未累及距下关节分别称为内侧或外侧旋转脱位,两者均极为罕见。我们描述了一例被忽视的内侧旋转脱位合并距骨头关节撞击伤的病例,通过切开复位并用两枚4毫米空心松质骨螺钉进行关节融合术进行治疗。在6个月的随访中,患者无疼痛,可完全负重行走。所有活动均无疼痛,且没有与鞋类相关的问题。X线片显示距舟关节融合良好。尽管是罕见损伤,但通过及时识别和治疗可取得良好效果。在被忽视的病例中,距舟关节融合术是一种可行的选择,尤其是存在关节损伤时。