English Connor J, Merriman David J, Austin Cindy L, Thompson Simon J
Mercy Hospital - Springfield, Emergency Trauma Center, 1235 E Cherokee, Springfield, MO 65804 USA.
Mercy Hospital - Springfield, Orthopedic Trauma, 3045 South National, MO 65804 USA.
J Orthop Case Rep. 2021 Oct;11(10):30-32. doi: 10.13107/jocr.2021.v11.i10.2454.
Talus fracture injuries are rare and most literature pertains to fractures in skeletally mature adults. It is unusual for pediatric talus fractures to be treated operatively and is normally treated with immobilization. The location of the talus fracture required a medial malleolar osteotomy to facilitate exposure and reduction, which was fixed with temporary smooth K-wires. The authors were unable to identify a previous description of this technique in the literature.
An 11-year-old female was referred to our hospital due to polytraumatic injuries sustained in a roll-over MVC. A displaced fracture of the talus body was present. Due to the fracture location, a medial malleolar osteotomy was required for exposure. An open reduction and internal fixation was performed using subchondral minifragment screws under general anesthesia. The patient healed uneventfully, regained a normal gait and full, pain-free range of motion.
Medial malleolar osteotomy with smooth K-wire fixation appears to be a safe method for gaining access to the talus when required for reduction and/or fixation of pediatric talus fractures.
距骨骨折损伤较为罕见，大多数文献涉及骨骼成熟成年人的骨折。小儿距骨骨折通常采用固定治疗，手术治疗并不常见。距骨骨折的位置需要进行内踝截骨以利于暴露和复位，并用临时光滑克氏针固定。作者在文献中未能找到对该技术的先前描述。
一名11岁女性因翻车机动车碰撞事故导致多处创伤被转诊至我院。存在距骨体移位骨折。由于骨折位置，需要进行内踝截骨以暴露。在全身麻醉下使用软骨下微型碎片螺钉进行切开复位内固定。患者愈合顺利，恢复了正常步态和完全无痛的活动范围。
对于小儿距骨骨折的复位和/或固定，在内踝截骨并用光滑克氏针固定似乎是一种安全的方法，可在需要时用于显露距骨。
