Tonogai Ichiro, Sairyo Koichi
Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima City, Tokushima, 770-8503, Japan.
Int J Surg Case Rep. 2021 Apr;81:105761. doi: 10.1016/j.ijscr.2021.105761. Epub 2021 Mar 13.
Legs are sometimes infected and swollen by cat bite or scratch. However, there is no report of synovitis with an enlarged talar posterior process in the posterior ankle caused by a cat bite or scratch which was treated by removal of the enlarged process and synovectomy with release of the flexor hallucis longus tendon via posterior ankle arthroscopy.
The patient was a 58-year-old woman who had started keeping a cat 7 months earlier. She subsequently sustained cat bite and scratch wounds to her lower legs, which gradually became increasingly swollen. On presentation, there was left lower leg swelling, particularly on the posterior aspect of the ankle. Imaging revealed bone marrow edema in the enlarged posterior talar process and inflammation of the adjacent soft tissue. We excised the enlarged posterior talar process, performed synovectomy, and released the flexor hallucis longus tendon using a posterior arthroscopic technique via standard posterolateral and posteromedial portals. Microbial culture was negative.
The patient returned to daily activities approximately 3 weeks after arthroscopic debridement. There was no recurrence at the 1-year follow-up visit. To our knowledge.
We report a rare case of posterior ankle synovitis with an enlarged posterior talar process caused by a cat bite or scratch which was treated successfully by posterior ankle arthroscopic debridement.
腿部有时会因猫咬或抓伤而感染肿胀。然而，尚无关于猫咬或抓伤导致后踝滑膜炎伴距骨后突增大，经后踝关节镜切除增大的后突并行滑膜切除术及松解拇长屈肌腱而治愈的报道。
患者为一名58岁女性，7个月前开始养猫。随后她小腿被猫咬伤和抓伤，伤口逐渐肿胀加剧。就诊时，左小腿肿胀，尤其是踝关节后方。影像学检查显示距骨后突增大处骨髓水肿及邻近软组织炎症。我们通过标准后外侧和后内侧入路，采用后关节镜技术切除增大的距骨后突，进行滑膜切除术，并松解拇长屈肌腱。微生物培养结果为阴性。
关节镜清创术后约3周患者恢复日常活动。1年随访时无复发。据我们所知。
我们报告了一例罕见的猫咬或抓伤导致后踝滑膜炎伴距骨后突增大，经后踝关节镜清创术成功治疗的病例。
