Case Report: Arthroscopic treatment of cedell fracture, shepherd fracture, and avulsion fracture at the insertion of the calcaneofibular ligament.

IF 1.6 4区 医学 Q2 SURGERY
Frontiers in Surgery Pub Date : 2025-03-25 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1490126
Sitong Zhang, Dejian Li, Qian Wang
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引用次数: 0

Abstract

Talar fractures represent less than 1% of all fractures, and combined fractures involving the posteromedial and posterolateral talar processes along with a lateral process fracture are exceptionally rare. These fractures are considered severe injuries that may lead to prolonged disability and persistent pain. The intricate anatomical configuration and the proximity of nerves and blood vessels surrounding the talus present substantial challenges in the management of posterior talar process fractures. Surgical procedures in this area are rare, and inadequate treatment may lead to significant discomfort and limitations in daily functioning for patients. In this case report, we describe a 45-year-old male who experienced a fall from a 2-meter height, leading to persistent right ankle swelling for 6 days. Radiographs, CT scans, and 3D-CT reconstructions identified fractures involving the posteromedial and posterolateral talar processes, as well as an avulsion fracture at the calcaneofibular ligament attachment site. To the best of our knowledge, there are no previously documented reports of this combined injury. We conducted arthroscopically assisted reduction and internal fixation through a posterior approach utilizing Herbert screw. The patient underwent a 4-year postoperative follow-up, during which favorable fracture healing was observed. The objective of this report is to demonstrate that arthroscopy offers a well-defined surgical field, aids in reduction and internal fixation, and to suggest a novel treatment approach for this uncommon fracture pattern.

病例报告:关节镜下治疗跟腓骨韧带插入处cedell骨折、shepherd骨折和撕脱骨折。
距骨骨折占所有骨折的不到1%,累及距骨后内侧和后外侧突的合并骨折以及外侧突骨折极为罕见。这些骨折被认为是严重损伤,可能导致长期残疾和持续疼痛。距骨后突骨折复杂的解剖结构和邻近的神经和血管对距骨后突骨折的治疗提出了重大挑战。该区域的外科手术很少,治疗不当可能导致患者严重不适和日常功能限制。在这个病例报告中,我们描述了一位45岁的男性,他经历了从2米高处坠落,导致右脚踝持续肿胀6天。x线片、CT扫描和3D-CT重建确定了涉及距骨后内侧和后外侧突的骨折,以及跟腓骨韧带附着部位的撕脱性骨折。据我们所知,以前没有关于这种合并损伤的文献报道。我们使用Herbert螺钉后路行关节镜辅助复位和内固定。术后随访4年,观察到骨折愈合良好。本报告的目的是证明关节镜提供了一个明确的手术范围,有助于复位和内固定,并建议一种新的治疗方法来治疗这种不常见的骨折类型。
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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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