Sánchez Carlos A, Gutierrez Daniela, Mendoza Whendy A, Niño Manuel E
Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colômbia.
Faculdade de Medicina, Pontificia Universidad Javeriana, Bogotá, Colômbia.
Rev Bras Ortop (Sao Paulo). 2022 Apr 25;59(Suppl 2):e233-e237. doi: 10.1055/s-0042-1744489. eCollection 2024 Nov.
Talar dislocation is an infrequent lesion, with variable outcomes reported in case reports and case series. Its epidemiology has not been elucidated to date, as this lesion is described in different ways: complete talar extrusion, closed or open dislocation, open dislocation with associated talar fracture, or open dislocation with malleolar fracture. Such classifications limit the possibility of evaluating this condition as a single pathology. There is also no consensus on which is the best treatment for this lesion. Many different treatment techniques have been described, including reimplantation with and without external fixation, early osteosynthesis, and even early talectomy and tibiocalcaneal pseudoartrhodesis. The outcomes of this type of injury can be as varied as the treatment options. The complications observed in the first year after the injury can be infection, avascular necrosis (AVN) and early posttraumatic osteoarthritis. The present paper reports adequate functional and radiological outcomes after one year of early reduction of a complete talar extrusion with osteosynthesis of a medial malleolar fracture.
距骨脱位是一种罕见的损伤，病例报告和病例系列中报道的结果各不相同。其流行病学至今尚未阐明，因为这种损伤有不同的描述方式：完全距骨挤出、闭合或开放性脱位、伴有距骨骨折的开放性脱位或伴有踝关节骨折的开放性脱位。此类分类限制了将这种情况作为单一病理进行评估的可能性。对于这种损伤的最佳治疗方法也没有共识。已经描述了许多不同的治疗技术，包括有或没有外固定的再植入、早期骨固定，甚至早期距骨切除和胫跟关节假关节形成术。这类损伤的结果与治疗选择一样多样。损伤后第一年观察到的并发症可能是感染、缺血性坏死（AVN）和创伤后早期骨关节炎。本文报告了在对一例完全距骨挤出并伴有内踝骨折进行早期复位及骨固定一年后获得的良好功能和影像学结果。
