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距骨体骨折。

Fracture of the body of the talus.

作者信息

Sneppen O, Christensen S B, Krogsoe O, Lorentzen J

出版信息

Acta Orthop Scand. 1977;48(3):317-24. doi: 10.3109/17453677708988775.

DOI:10.3109/17453677708988775
PMID:920125
Abstract

Fifty-one patients with fracture of the body of the talus were seen at follow-up examination an average of 23 months after treatment. Osteonecrosis had developed in 8 out of 17 patients with displaced shearing or crush fractures of the trochlea. Malunion as well as subluxation predisposed to osteoarthrosis in the subtalar and talocrural joints. Thus, osteoarthrosis was present in 9 out of 21 patients without malunion, in 8 out of 16 patients with malunion, and in 11 out of 14 with malunion as well as subluxation. Judging from the nature of the complaints, the difficulties in rehabilitation, and the disability assessment, the prognosis was fairly grave, also after the small, usually non-displaced fractures of the posterior and lateral tubercles. Out of 20 patients with fractures of this type only 6 obtained almost complete relief from their symptoms, only 8 could go back to their previous work on a full-time basis, and 11 were assessed to be 10 per cent or more disabled. Fractures in the posterior and lateral tubercles must therefore be interpreted as links in more extensive injuries involving the subtalar joint and possibly the talocrural joint with associated injuries to articular cartilage, joint capsules, and ligaments.

摘要

51例距骨体骨折患者在治疗后平均23个月接受随访检查。在17例滑车移位剪切或挤压骨折患者中,有8例发生了骨坏死。畸形愈合以及半脱位易导致距下关节和距小腿关节发生骨关节炎。因此,在21例无畸形愈合的患者中有9例出现骨关节炎,在16例有畸形愈合的患者中有8例出现骨关节炎,在14例有畸形愈合及半脱位的患者中有11例出现骨关节炎。从主诉的性质、康复的困难程度以及残疾评估来看,预后相当严重,即使是后结节和外侧结节通常无移位的小骨折也是如此。在20例此类骨折患者中,只有6例症状几乎完全缓解,只有8例能够全职回到原来的工作岗位,11例被评估为残疾程度达10%或更高。因此,后结节和外侧结节骨折必须被视为涉及距下关节以及可能累及距小腿关节的更广泛损伤的一部分,同时伴有关节软骨、关节囊和韧带的相关损伤。

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