Objective： To review the operative technique of trephine arthrodesis of subtalar joints and evaluate its clinical effect. Methods： From June 1998 to October 2006, we performed subtalar arthrodesis on 38 feet of 34 ...Objective： To review the operative technique of trephine arthrodesis of subtalar joints and evaluate its clinical effect. Methods： From June 1998 to October 2006, we performed subtalar arthrodesis on 38 feet of 34 patients for a variety of painful disorders of hindfoot with trephine technique. Clinical and radiologic follow-up evaluations were performed for 45 months on average （range, 21 to 110 months） after arthrodesis. Results： No severe complications were found in this study except one patient with dropfoot and two with skin necrosis. The average ankle-hindfoot scores of the American Orthopaedic Foot and Ankle Society （AOFAS） was improved from 48.3 preoperatively to 79.2 postoperatively （P〈0.05）. The pain scores of visual analogue scales （VAS） decreased from 7.2 （range, 3 to 10） preoperatively to 2.6 （range, 1 to 6） post operatively （P〈0.05）. Subjectively, the patients experienced improvements in pain, function, cosmesis, and shoewearing. Overall, 30 patients were satisfied and all patients would have this procedure again under similar circumstances. Postoperative radiology showed that complete union was found in 35 feet 6 months after operation, with the successful union rate of 92.1%. There was an increase in arthritic scores for 5 ankles, 4 talonavicular joints, 4 calcaneocuboid joints, and 4 midfoot joints. Nonunion occurred in 3 subtalar joints with anterolateral approach, which required revision arthrodesis. Conclusion： Isolated subtalar arthrodesis with trephine method is an effective procedure for painful malalignment of hindfoot.展开更多
Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if misdiagnosed. The appropriate management of these fractures is still controversial and only a few reports are ava...Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if misdiagnosed. The appropriate management of these fractures is still controversial and only a few reports are available on this subject. We presented a case of a 37-year-old male with neglected fracture on the lateral process of talus which was misdiagnosed at the time of injury. The patient presented to 7 months after misdiagnosis with a chronic ankle pain. Our case is unique in the sense that it is a rare case of neglected fracture on the lateral process of taluswhich presented as a loose body in sinus tarsi. However, a surgery with an excision of the loose body presented a satisfactory outcome along with 2 years＇ follow-up. To our knowledge, it ought to he the first case reported in the English literature. Through this case report, we highlight the importance of high index of suspicion for such rare bony injuries while evaluating trauma to the lateral side of ankle and discuss the principles of management of these fractures.展开更多
文摘Objective： To review the operative technique of trephine arthrodesis of subtalar joints and evaluate its clinical effect. Methods： From June 1998 to October 2006, we performed subtalar arthrodesis on 38 feet of 34 patients for a variety of painful disorders of hindfoot with trephine technique. Clinical and radiologic follow-up evaluations were performed for 45 months on average （range, 21 to 110 months） after arthrodesis. Results： No severe complications were found in this study except one patient with dropfoot and two with skin necrosis. The average ankle-hindfoot scores of the American Orthopaedic Foot and Ankle Society （AOFAS） was improved from 48.3 preoperatively to 79.2 postoperatively （P〈0.05）. The pain scores of visual analogue scales （VAS） decreased from 7.2 （range, 3 to 10） preoperatively to 2.6 （range, 1 to 6） post operatively （P〈0.05）. Subjectively, the patients experienced improvements in pain, function, cosmesis, and shoewearing. Overall, 30 patients were satisfied and all patients would have this procedure again under similar circumstances. Postoperative radiology showed that complete union was found in 35 feet 6 months after operation, with the successful union rate of 92.1%. There was an increase in arthritic scores for 5 ankles, 4 talonavicular joints, 4 calcaneocuboid joints, and 4 midfoot joints. Nonunion occurred in 3 subtalar joints with anterolateral approach, which required revision arthrodesis. Conclusion： Isolated subtalar arthrodesis with trephine method is an effective procedure for painful malalignment of hindfoot.
文摘Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if misdiagnosed. The appropriate management of these fractures is still controversial and only a few reports are available on this subject. We presented a case of a 37-year-old male with neglected fracture on the lateral process of talus which was misdiagnosed at the time of injury. The patient presented to 7 months after misdiagnosis with a chronic ankle pain. Our case is unique in the sense that it is a rare case of neglected fracture on the lateral process of taluswhich presented as a loose body in sinus tarsi. However, a surgery with an excision of the loose body presented a satisfactory outcome along with 2 years＇ follow-up. To our knowledge, it ought to he the first case reported in the English literature. Through this case report, we highlight the importance of high index of suspicion for such rare bony injuries while evaluating trauma to the lateral side of ankle and discuss the principles of management of these fractures.
