Dept of Orthopaedics, SL Raheja Hospital, Mumbai, Maharashtra, India.
Dept of Traumatology and Surgery, Kamothe, Navi-Mumbai, Maharsahtra, India.
Foot (Edinb). 2021 Jun;47:101797. doi: 10.1016/j.foot.2021.101797. Epub 2021 Apr 8.
Displaced isolated fractures of sustentaculum tali are rare. Inadequate treatment of these injuries can rarely lead to non-union or mal-union and in most cases are treated non-surgically. We report a unique case of undiagnosed mal-union of sustentaculum tali in the setting of underlying tarsal coalition that resulted in symptoms of tarsal tunnel. Osteotomy and excision of the mal-united fragment and coalition along with decompression of the tarsal tunnel was performed. The patient had immediate improvement in pain and the paraesthesia recovered by the end of 6 weeks post-operatively. The Foot and Ankle disability score (FADI) score improved from 26.0 pre-operatively to 96.2 at 3 years' follow-up. This case highlights that isolated fractures of sustentaculum tali warrant advanced imaging and surgical reduction and fixation may be appropriate to avoid long-term disability where displacement compromises the tarsal tunnel or function of the subtalar joint.
距骨突游离骨折较为少见。这些损伤若处理不当，极少数情况下可能会导致骨不连或畸形愈合，大多数情况下采取非手术治疗。我们报告了一例独特的距骨突畸形愈合病例，该病例合并有跗骨联合，导致跗管症状。我们对其进行了距骨突切开复位术和畸形愈合骨块及联合骨切除术，并对跗管进行了减压。术后 6 周，患者疼痛立即改善，感觉异常完全恢复。足部功能残疾评分（FADI）从术前的 26.0 分提高到 3 年后的 96.2 分。本病例强调，孤立的距骨突骨折需要进行高级影像学检查，手术复位和固定可能是合适的，以避免因移位累及跗管或距下关节功能而导致长期残疾。
