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距骨后关节面骨折合并开放性内侧距下关节脱位1例罕见病例

A Rare Case of Fractured Posterior Facet of the Talus in Association With Open Medial Subtalar Dislocation.

作者信息

Ahmed Adnan, Balaji Muthukumar S, Naidu Dilip Kumar, Patel Hardik L, Krishna Vamsi

机构信息

Department of Orthopaedics, SRM Medical College Hospital and Research Centre, Chennai, IND.

出版信息

Cureus. 2021 Feb 8;13(2):e13224. doi: 10.7759/cureus.13224.

Abstract

Subtalar or peritalar dislocation is the loss of contact between the articular surface of the talus distally and the calcaneum and navicular. In this paper, a case of open medial type of subtalar dislocation associated with fractured posterior facet of the talus in a 27-year-old man with a history of road traffic accident was reported. Immediate wound irrigation and open reduction under general anesthesia at the emergency room operation theater was successful followed by cast immobilization. At one-year follow-up, the patient was walking and carrying out his daily activities with mild restriction of inversion and eversion movements. Extensive wound debridement followed by immediate reduction and, when required, stabilization are the principal features of management. Open subtalar dislocation is an extremely rare injury and often poses a treatment dilemma. Early debridement and open reduction of the dislocation like in our case can give good functional outcome for an open medial subtalar dislocation at one-year follow-up. Temporary stabilization of dislocation in the form of Kirschner wires maybe needed in some cases only.

摘要

距下关节或距周关节脱位是指距骨远端关节面与跟骨和舟骨之间失去接触。本文报道了1例27岁男性道路交通事故患者,发生开放性内侧型距下关节脱位并伴有距骨后关节面骨折。在急诊手术室全身麻醉下立即进行伤口冲洗和切开复位,随后进行石膏固定。随访1年时,患者可行走并进行日常活动,但内翻和外翻运动略有受限。广泛的伤口清创,随后立即复位,必要时进行固定,是治疗的主要特点。开放性距下关节脱位是一种极其罕见的损伤,常常带来治疗难题。像我们病例中那样早期清创和切开复位脱位,在随访1年时可为开放性内侧距下关节脱位带来良好的功能预后。仅在某些情况下可能需要以克氏针的形式临时固定脱位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a770/7946109/c65652a410fa/cureus-0013-00000013224-i01.jpg

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