Heck B E, Ebraheim N A, Jackson W T
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699, USA.
Foot Ankle Int. 1996 Feb;17(2):103-6. doi: 10.1177/107110079601700208.
Irreducible medial subtalar dislocation has been associated with the talar head "buttonholing" through the extensor digitorum brevis (EDB) muscle, entrapment of the talar head in the extensor retinaculum, talonavicular impaction, interpositioning of the EDB muscle between the talus and navicular, and buttonholing of the talar head through the talonavicular ligament and joint capsule. Cadaver analysis of the medial subtalar dislocation in this study supported entrapment of the talar head in the extensor retinaculum and talonavicular impaction as well as impingement of the deep peroneal nerve and associated dorsalis pedis arterial branches between the talus and navicular as causes of irreducible subtalar dislocation. In this study, the talar head was not noted to buttonhole through or entrap the EDB muscle. This is the first report of the deep peroneal nerve implicated as a possible cause of irreducible medial subtalar dislocation.
不可复位的距下关节内侧脱位与距骨头经趾短伸肌“纽扣孔样”穿出、距骨头被伸肌支持带卡压、距舟关节撞击、趾短伸肌在距骨和舟骨之间嵌入以及距骨头经距舟韧带和关节囊穿出有关。本研究对距下关节内侧脱位的尸体分析支持距骨头被伸肌支持带卡压、距舟关节撞击以及在距骨和舟骨之间腓深神经及其相关的足背动脉分支受撞击是导致距下关节不可复位脱位的原因。在本研究中，未发现距骨头经趾短伸肌穿出或被其卡压。这是首次报道腓深神经可能是距下关节内侧不可复位脱位的原因。
