TRAUMATICKÁ ASTRAGALEKTÓMIA – kazuistika

English version

Autoři: Jaroslav Cigaňák; Tomáš Cigaňák; Dušan Magdin; Vladimír Gaman
Působiště autorů: Department of Trauma and Orthopedic Surgery, Hospital Bojnice, Slovakia ; Traumatologicko-ortopedické oddelenie, Nemocnica v Bojniciach
Vyšlo v časopise: Úraz chir. 22., 2014, č.3

Souhrn

The authors refer to a rare traumatic astragalectomy performed on a 26-year-old motorcyclist who had crashed into a field. A severe open wound and contaminated devastation of the ankle and leg required acute surgical revision, where it was determined that the entire astragalus (talus bone) had been lost. Given the serious nature of the high-energy open wound, endangering foot vitality, and after having thoroughly revised and debrided devitalized soft tissue, crural-calcaneal osteosynthesis was done with an external fixator during Period I. When the soft tissue had healed, a crural-calcaneal spongioplasty was performed over ten months during Period II for the purpose of arthrodesis, using three screws through the calcaneus and tibia. After a further year, Period III saw osteosynthetic material removed while exercise and rehabilitation continued. Five years after the accident the patient was walking without a cane and with minimal limping. In general, the authors didactically suggest an astragalectomy broken down according to cause: 1. Non-traumatic - severe foot and ankle deformities and post-infections (e.g., past history of tuberculosis); 2. Post-traumatic – only rarely mentioned in the literature and covering comminuted and dislocated fractures of the talus bone. 3. Traumatic - when an accident causes either discontinuity of the talus bone with its original location or full loss.

Key words:
Astragalectomy, open talus dislocation.

Zdroje

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