Kanwat Himanshu, Mittal Samarth, Trikha Vivek
Deptt. of Orthopaedics, AIIMS, U-24/21, Pink Town Houses, DLF-III, Gurgaon, Haryana, 122002, New Delhi, India.
Dept. of Orthopaedics, JPNATC, AIIMS, 4th Floor, JPNATC, Raj Nagar, 110029, New Delhi, India.
J Clin Orthop Trauma. 2019 Aug 13;15:168-171. doi: 10.1016/j.jcot.2019.08.013. eCollection 2021 Apr.
Talonavicular dislocation is a rare injury. 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 rare case of neglected medial swivel dislocation with concomitant calcaneus, cuboid and 5th metatarsal fracture, which was managed with open reduction and fixation of talonavicular joint with k-wires and an external distractor. At 1 year follow up the patient was mobilizing full weight bearing without any pain or deformity, the radiographs showing well located talonavicular joint and healed calcaneus, cuboid and 5th metatarsal fractures. This is the first reported case of medial swivel talonavicular dislocation with associated calcaneum, cuboid and 5th metatarsal fracture to the best of our knowledge. This case report highlights the importance of maintaining high level of suspicion for diagnosing midfoot injuries in a polytraumatized patient as well as need of accurate and timely reduction of dislocation for good functional outcome.
Level 4.
距舟关节脱位是一种罕见的损伤。孤立的内侧或外侧距舟关节脱位且不伴有距下关节破坏分别称为内侧或外侧旋转脱位，两者均极为罕见。我们描述了一例罕见的被漏诊的内侧旋转脱位病例，同时伴有跟骨、骰骨和第5跖骨骨折，该病例采用克氏针和外固定架对距舟关节进行切开复位固定治疗。随访1年时，患者可完全负重行走，无任何疼痛或畸形，X线片显示距舟关节位置良好，跟骨、骰骨和第5跖骨骨折已愈合。据我们所知，这是首例报道的伴有跟骨、骰骨和第5跖骨骨折的内侧旋转距舟关节脱位病例。本病例报告强调了对于多发伤患者中足损伤的诊断要保持高度怀疑的重要性，以及为获得良好功能结局而准确及时复位脱位的必要性。
4级。
