关键词: Cedell's fracture ankle sprain flexor hallucis longus posterior ankle impingement

Mesh : Adolescent Ankle Injuries / diagnostic imaging therapy Athletic Injuries Bed Rest Conservative Treatment / methods Follow-Up Studies Fracture Healing / physiology Fractures, Bone / classification diagnostic imaging therapy Humans Imaging, Three-Dimensional Immobilization / methods Injury Severity Score Magnetic Resonance Imaging / methods Male Rare Diseases Talus / diagnostic imaging injuries Time Factors Tomography, X-Ray Computed Treatment Outcome

来  源:   DOI:10.1053/j.jfas.2016.02.001   PDF(Sci-hub)

Abstract:
We describe a rare case of a fracture of the medial tubercle of the posterior process of the talus in a 16-year-old male athlete who fell during basketball practice. The patient presented to our orthopedic clinic when pain and swelling had persisted despite 2 weeks of anti-inflammatory medication and rest. Computed tomography and magnetic resonance imaging scans revealed a fracture of the posteromedial tubercle of the talus and a small amount of retained fluid in the joint. Immobilization with a below-the-knee cast and non-weightbearing for 4 weeks, with a gradual return to full activity, was successful. At the 1-year follow-up evaluation, the patient expressed no complaints. Fracture of the posteromedial tubercle of the talus will usually result in a misdiagnosis or delayed diagnosis owing to the insidious onset of symptoms. We believe the present fracture configuration resulted from the vertical compression force that occurred on landing by posterior medial ankle impingement in plantarflexion-supination, modifying the conventional concept of the posteromedial tubercle fracture. We also present a suggested classification with a flowchart diagram.
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