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Chronic closed talus dislocation: a rare presentation and treatment dilemma.

机译:慢性闭合距骨脱位:一种罕见的表现和治疗难题。

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摘要

A chronic presentation of closed dorsolateral dislocation of the talus is a rare injury. A 35-year-old woman presented with pain and deformity of the right foot of 6 months' duration. Her medical history was significant for rheumatoid arthritis, for which she was being treated with steroids. Radiographs and computed tomography of the right foot showed dorsolateral talar dislocation with fracture of the medial malleolus. Dislocation of the talus from the tibiotalar, talocalcaneal, and talonavicular joints was indicative of talus dislocation with a fracture of the medial malleolus rather than a fracture-dislocation of the ankle joint. Because of chronic presentation of the injury and an inability to reduce this talus dislocation by closed methods, open total talectomy was performed. At 2-year follow-up, the patient had an AOFAS score of 78. The patient had an obvious limp on the affected limb but managed her activities of daily living well without a shoe raise or brace. Because of the severe varus inversion deformity of the foot preoperatively, the patient was not able to walk. Postoperatively, the deformity was corrected and the patient was able to stand and walk; she was satisfied with the outcome of the surgery.To our knowledge, this is the first report of chronic closed dorsolateral talus dislocation. We recommend that chronic closed isolated dorsolateral talus dislocation can be effectively managed by total talectomy.
机译:闭合性距骨背外侧脱位的慢性表现是罕见的损伤。一名35岁的女性,右脚疼痛和畸形持续了6个月。她的病史对类风湿关节炎有重要意义,因此接受类固醇治疗。右脚的X射线照片和计算机断层扫描显示背外侧距骨脱位伴内踝骨折。距骨距胫距骨,距踝关节和距骨头的关节脱位表明距骨脱位伴有内踝骨折,而不是踝关节骨折脱位。由于慢性损伤的表现,并且无法通过封闭方法减少距骨脱位,因此进行了开放性全距骨切除术。在2年的随访中,患者的AOFAS评分为78。患者的患肢明显li行,但日常生活活动良好,没有举鞋或撑鞋。由于术前脚严重内翻内翻畸形,患者无法行走。术后矫正了畸形,患者能够站立和行走;她对手术的结果感到满意。据我们所知,这是慢性闭合性背外侧距骨脱位的首次报道。我们建议可以通过全距骨切除术有效地治疗慢性闭合性孤立性背外侧距骨脱位。

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