Kanemitsu Munekazu, Nakasa Tomoyuki, Ikuta Yasunari, Nekomoto Akinori, Adachi Nobuo
Department of Orthopaedic Surgery, Matsuyama Red Cross Hospital, Matsuyama, JPN.
Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN.
Cureus. 2025 May 22;17(5):e84598. doi: 10.7759/cureus.84598. eCollection 2025 May.
Fracture of the lateral process of the talus (FLPT) is a rare injury. FLPT is frequently missed or diagnosed late, often leading to nonunion, malunion, or subtalar osteoarthritis. We present a case of a 44-year-old male with schizophrenia who sustained an FLPT after falling downstairs. Initial radiographs missed the injury, and conservative treatment was pursued despite the presence of bone fragments. After four months, persistent pain led to further imaging, revealing subtalar joint osteoarthritis. Surgical intervention was required due to nonunion and large, displaced bone fragments. A 4 cm incision was made, and the fracture site was refreshed and fixed using screws with bone grafting. Postoperatively, the patient showed significant improvement, with complete bone union and enhanced joint space after one year. At the last follow-up (three years after surgery), the patient was able to work without difficulty. Late diagnosis and non-aggressive treatment can lead to poor prognosis, with late complications, including nonunion, malunion, bony overgrowth, and subtalar osteoarthritis. We presented a case of nonunion of the lateral process of the talus with osteoarthritis of the subtalar joint. A good clinical outcome was achieved by fixing the fracture and stabilizing the subtalar joint.
距骨外侧突骨折(FLPT)是一种罕见的损伤。FLPT经常被漏诊或诊断较晚,常导致骨不连、畸形愈合或距下关节炎。我们报告一例44岁患有精神分裂症的男性患者,其在从楼梯上摔下后发生了FLPT。最初的X线片漏诊了该损伤,尽管存在骨碎片仍采取了保守治疗。四个月后,持续的疼痛导致进一步影像学检查,发现距下关节骨关节炎。由于骨不连以及大的、移位的骨碎片,需要进行手术干预。做了一个4厘米的切口,使用螺钉固定骨折部位并进行植骨,使骨折部位复位。术后,患者有显著改善,一年后实现了完全骨愈合且关节间隙增宽。在最后一次随访(术后三年)时,患者能够毫无困难地工作。延迟诊断和不积极的治疗可导致预后不良,出现包括骨不连、畸形愈合、骨质过度生长和距下关节炎等晚期并发症。我们报告了一例距骨外侧突骨不连合并距下关节骨关节炎的病例。通过固定骨折和稳定距下关节取得了良好的临床效果。