Jadib Imad, Abdennaji Soufiane, Rachidi Houssam Eddine, Messoudi Abdeljebbar, Rafai Mohamed
Department of Orthopedics and Trauma-Surgery P32, University Hospital Center IBN Rochd, Casablanca, Morocco.
Department of Orthopedics and Trauma-Surgery P32, University Hospital Center IBN Rochd, Casablanca, Morocco.
Int J Surg Case Rep. 2024 Jul;120:109782. doi: 10.1016/j.ijscr.2024.109782. Epub 2024 May 24.
The combination of talar neck fractures with malleolar fractures is a rare. This rare association accounts for 0.3 % of all bone fractures. We describe a one-of-a-kind ankle dislocation with a talar neck fracture and a bimalleolar fracture.
A 24-year-old male patient presented to the emergency department after a traffic accident. A physical examination revealed swelling and tenderness in the left ankle. The radiograph and the CT scan showed a Hawkins type III comminuted talar neck fracture, with an oblique fracture of the medial malleolus and an infra-syndesmotic fracture of the lateral malleolus. The patient underwent open reduction and internal fixation involving screw fixation for talar neck fracture and the medial malleolus and plating for the lateral malleolus. The treatment and post-operative follow-up showed successful healing and functional recovery, with a score of 85 on the American Orthopedic Foot and Ankle Society ankle-hindfoot at the last follow up.
The discussion includes insights on the rarity of this fracture combination, treatment challenges, and potential complications such as avascular necrosis. This article emphasizes the importance of achieving anatomical reduction and stable fixation for optimal outcomes in such complex fractures.
This case report highlights the successful treatment of a rare combination of talar neck and bimalleolar ankle fractures, emphasizing the importance of anatomical reduction and stable fixation for optimal outcomes in complex fractures.
距骨颈骨折合并踝关节骨折较为罕见。这种罕见的联合骨折占所有骨折的0.3%。我们描述了一例独特的踝关节脱位合并距骨颈骨折和双踝骨折。
一名24岁男性患者在交通事故后被送往急诊科。体格检查发现左踝肿胀和压痛。X线片和CT扫描显示为Hawkins III型粉碎性距骨颈骨折，内踝斜形骨折，外踝下胫腓联合以下骨折。患者接受了切开复位内固定术，包括距骨颈骨折和内踝的螺钉固定以及外踝的钢板固定。治疗及术后随访显示愈合良好且功能恢复，末次随访时美国矫形足踝协会踝-后足评分为85分。
讨论内容包括对这种骨折联合的罕见性、治疗挑战以及潜在并发症（如缺血性坏死）的见解。本文强调了在这类复杂骨折中实现解剖复位和稳定固定以获得最佳治疗效果的重要性。
本病例报告突出了对距骨颈和双踝骨折这种罕见联合骨折的成功治疗，强调了解剖复位和稳定固定在复杂骨折中获得最佳治疗效果的重要性。
