6个月大忽视距骨颈骨折1例并文献复习

Nagaraj Manju Moger, Pragadeeshwaran J, M. Sarkar, P. Meena
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引用次数: 0

摘要

距骨骨折非常罕见,约占足部和踝关节周围骨折的1%距骨颈骨折很可能破坏吻合环,导致距骨体血液供应中断,从而导致骨折愈合和完整性方面的重大问题。由于缺乏足够的放射学和临床检查,大约39%的足中部和踝关节骨折在最初评估时可能被遗漏。在这些遗漏的损伤中,大约50%是距骨骨折。一名23岁男性患者来就诊,主诉走路时左脚疼痛6个月。六个月前他曾从10英尺高的地方摔下来。他在当地一家医院接受了保守治疗,没有得到任何适当的诊断。6个月后,他向我们提出慢性,隐痛,持续疼痛,行走和站立时加剧。影像学诊断距骨颈骨折不愈合,采用切开复位、空心松质螺钉内固定及同侧髂骨松质骨移植治疗。缺乏及时的诊断会加剧血管损伤,延误及时的干预,并增加发病率。
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Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature
Talus fractures are very rarely seen and account for approximately 1 percent of fractures around the foot and ankle Talar neck fractures are likely to damage the anastomotic ring, resulting in disruption of blood supply to the talar body which leads to significant problems in fracture healing and integrity. Approximately 39 percent of midfoot and ankle fractures could be missed during initial evaluation due to a lack of adequate radiological and clinical examination. Among these missed injuries approximately 50 percent are talus fractures. A 23-year-old male patient came with complaints of pain over the left foot while walking for 6 months. He had a history of falls from 10 feet height 6 months back. He was conservatively managed in a local hospital without any proper diagnosis. He presented to us 6 months later with chronic, dull aching, continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with ipsilateral iliac crest cancellous bone grafting. Lack of timely diagnosis escalates the vascular insult, delays timely intervention, and increases morbidity.
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