[胫骨后神经血管束压迫致无法复位的外侧尺下骨折脱位1例报告]。

Acta ortopedica mexicana Pub Date : 2025-07-01
E Guillén-Botaya, I Polo-Pérez, C Blasco-Molla, F Forriol-Brocal, A Silvestre-Muñoz
{"title":"[胫骨后神经血管束压迫致无法复位的外侧尺下骨折脱位1例报告]。","authors":"E Guillén-Botaya, I Polo-Pérez, C Blasco-Molla, F Forriol-Brocal, A Silvestre-Muñoz","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>subtalar dislocations, typical of high-energy trauma, are classified as medial, lateral, anterior or posterior depending on the deviation of the foot in relation to the talus. Lateral dislocation accounts for 17% of the total and has a worse prognosis. Immediate reduction is required to reduce the risk of sequelae, the incidence of which is around 90%.</p><p><strong>Objective: </strong>a case of lateral subtalar dislocation is presented; a review of the literature on its diagnosis, treatment and prognosis is carried out.</p><p><strong>Clinical case: </strong>a 46-year-old woman fell from a height of 3 meters, with severe deformity in the hindfoot. There was good distal vascular coloration, but no pulse or posterior tibial sensitivity could be identified. In addition, she had a medial sulcocutaneous fold under the head of the talus. Plain radiograph and CT revealed lateral subtalar dislocation, with fracture of the sustentaculum tali, and a \"fleck sign\" in the posterior region of the distal fibula. Suspecting soft tissue incarceration, a medial approach was performed, observing interposition of the posterior tibial neurovascular bundle. After joint reduction, the sustentaculum tali and the \"fleck sign\" were osteosynthesized. In addition, a complete section of the long lateral peroneal tendon was identified, which was tenodesed to the short peroneal tendon. Finally, an external fixator was placed. After eight weeks, the fixator was removed and weight bearing was authorized; after six months, mobility was complete and hypoesthesia persisted only in the plantar pad.</p><p><strong>Conclusions: </strong>lateral subtalar dislocation is an uncommon entity with a poor prognosis. Adequate interpretation through a thorough examination and pre-reduction CT of the bone and soft tissue lesions minimizes future sequelae.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"242-248"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Irreductable lateral subatalar fracture-dislocation by entrapment of the posterior tibial neurovascular bundle: case report].\",\"authors\":\"E Guillén-Botaya, I Polo-Pérez, C Blasco-Molla, F Forriol-Brocal, A Silvestre-Muñoz\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>subtalar dislocations, typical of high-energy trauma, are classified as medial, lateral, anterior or posterior depending on the deviation of the foot in relation to the talus. Lateral dislocation accounts for 17% of the total and has a worse prognosis. Immediate reduction is required to reduce the risk of sequelae, the incidence of which is around 90%.</p><p><strong>Objective: </strong>a case of lateral subtalar dislocation is presented; a review of the literature on its diagnosis, treatment and prognosis is carried out.</p><p><strong>Clinical case: </strong>a 46-year-old woman fell from a height of 3 meters, with severe deformity in the hindfoot. There was good distal vascular coloration, but no pulse or posterior tibial sensitivity could be identified. In addition, she had a medial sulcocutaneous fold under the head of the talus. Plain radiograph and CT revealed lateral subtalar dislocation, with fracture of the sustentaculum tali, and a \\\"fleck sign\\\" in the posterior region of the distal fibula. Suspecting soft tissue incarceration, a medial approach was performed, observing interposition of the posterior tibial neurovascular bundle. After joint reduction, the sustentaculum tali and the \\\"fleck sign\\\" were osteosynthesized. In addition, a complete section of the long lateral peroneal tendon was identified, which was tenodesed to the short peroneal tendon. Finally, an external fixator was placed. After eight weeks, the fixator was removed and weight bearing was authorized; after six months, mobility was complete and hypoesthesia persisted only in the plantar pad.</p><p><strong>Conclusions: </strong>lateral subtalar dislocation is an uncommon entity with a poor prognosis. Adequate interpretation through a thorough examination and pre-reduction CT of the bone and soft tissue lesions minimizes future sequelae.</p>\",\"PeriodicalId\":101296,\"journal\":{\"name\":\"Acta ortopedica mexicana\",\"volume\":\"39 4\",\"pages\":\"242-248\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta ortopedica mexicana\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta ortopedica mexicana","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

简介:距下脱位是典型的高能创伤,根据足相对距骨的偏差分为内侧、外侧、前部或后部。外侧脱位占全部脱位的17%,预后较差。需要立即减少,以减少后遗症的风险,其发生率约为90%。目的:报告一例外侧距下脱位;本文对其诊断、治疗和预后的文献进行综述。临床病例:46岁女性,从3米高处坠落,后足严重畸形。远端血管染色良好,但未见脉搏或胫骨后端敏感。此外,她在距骨头部下方有内侧皮沟。x线平片和CT显示外侧距下脱位,伴talentaculum骨折,腓骨远端后区有“斑点征”。怀疑软组织嵌顿,进行内侧入路,观察胫骨后神经血管束的介入。关节复位后,将其支撑骨和“斑点征”进行骨合成。此外,鉴定了腓骨外侧长肌腱的完整部分,该部分与腓骨短肌腱连接。最后,放置外固定架。8周后,取下固定架,允许负重;6个月后,活动能力完全恢复,仅足底感觉减退。结论:外侧距下脱位是一种少见的疾病,预后较差。通过彻底的检查和预复位CT对骨骼和软组织病变进行充分的解释,最大限度地减少未来的后遗症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Irreductable lateral subatalar fracture-dislocation by entrapment of the posterior tibial neurovascular bundle: case report].

Introduction: subtalar dislocations, typical of high-energy trauma, are classified as medial, lateral, anterior or posterior depending on the deviation of the foot in relation to the talus. Lateral dislocation accounts for 17% of the total and has a worse prognosis. Immediate reduction is required to reduce the risk of sequelae, the incidence of which is around 90%.

Objective: a case of lateral subtalar dislocation is presented; a review of the literature on its diagnosis, treatment and prognosis is carried out.

Clinical case: a 46-year-old woman fell from a height of 3 meters, with severe deformity in the hindfoot. There was good distal vascular coloration, but no pulse or posterior tibial sensitivity could be identified. In addition, she had a medial sulcocutaneous fold under the head of the talus. Plain radiograph and CT revealed lateral subtalar dislocation, with fracture of the sustentaculum tali, and a "fleck sign" in the posterior region of the distal fibula. Suspecting soft tissue incarceration, a medial approach was performed, observing interposition of the posterior tibial neurovascular bundle. After joint reduction, the sustentaculum tali and the "fleck sign" were osteosynthesized. In addition, a complete section of the long lateral peroneal tendon was identified, which was tenodesed to the short peroneal tendon. Finally, an external fixator was placed. After eight weeks, the fixator was removed and weight bearing was authorized; after six months, mobility was complete and hypoesthesia persisted only in the plantar pad.

Conclusions: lateral subtalar dislocation is an uncommon entity with a poor prognosis. Adequate interpretation through a thorough examination and pre-reduction CT of the bone and soft tissue lesions minimizes future sequelae.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信