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Closed medial total subtalar joint dislocation without ankle fracture: a case report

机译:闭合内侧距下全关节脱位,无踝关节骨折1例

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Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain.
机译:引言距下颌全脱位而没有踝关节骨折是一种罕见的临床表现;这通常是由于创伤性高能机制引起的。标准治疗是在全身麻醉下成功闭合闭合复位,然后负重和踝关节固定并用膝盖以下石膏固定6周。案例介绍我们介绍了一名30岁的摩洛哥妇女,该妇女参与了道路交通事故。随后,她接受了放射学评估,该评估的目的是使距骨下完全脱位,而没有踝部骨折。她立即​​被送入手术室,在镇静下立即复位手术,并在石膏靴中固定8周。根据文献讨论该创伤性病变的处理。结论距下内侧脱位是一种罕见的脱位,通常不被视为运动损伤,因为它需要转移大量的动能。与相对较强的钙维管韧带相比,较弱的管和距骨韧带通常首当其冲,并且更容易被破坏。紧急复位很重要,在全身麻醉下闭合复位通常是成功的,通常通过使膝盖保持弯曲以放松腓肠肌来促进。长期后遗症包括距骨无血管坏死和骨软骨骨折,以及慢性不稳定性和疼痛。

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