PDF(Pubmed)
Abstract：
The middle cuneiform is the keystone of the transverse arch and is located between the medial cuneiform and lateral cuneiforms. Isolated middle cuneiform plantar dislocations are rare injuries due to their shape and ligamentous structural connections. A 20-year-old female patient was admitted to the emergency service of another clinic after a 70 kg iron tractor piece fell on her foot 20 days before she was referred to our clinic. Conservative treatment with a short leg circular cast was applied, considering that there was a fracture in the cuneiforms on X-ray imaging. The patient, who was re-evaluated at the second-week follow-up, was referred to our hospital considering the complex injury of the cuneiforms. There was tenderness over the cuneiform in the physical examination. X-ray and computed tomography images of the patient revealed plantar dislocation of the middle cuneiform bone. with subluxation of the medial cuneiform. Open reduction and internal fixation were performed for the middle cuneiform. During the six-month follow-up, the patient had no complaints and was able to do routine work. No lucency or arthritic changes were observed in the X-ray at the 22-month control. Plantar middle cuneiform dislocations are rare and late diagnosis can lead to poor results. This case is presented to emphasize the importance of considering this rare injury and using advanced imaging studies when necessary, considering the mechanism of injury.
摘要：
中间楔形文字是横向弓的基石，位于内侧楔形文字和外侧楔形文字之间。孤立的中楔形足底脱位由于其形状和韧带结构连接而罕见。一名20岁的女性患者在转诊到我们的诊所前20天，一只70公斤重的铁拖拉机从脚上摔了下来，因此被送往另一家诊所的急诊服务。采用短腿圆形石膏保守治疗，考虑到X射线成像的楔形文字骨折。病人,在第二周的随访中重新评估，考虑到楔形文字的复杂损伤，被转诊到我们医院。体检中楔形文字有压痛。患者的X射线和计算机断层扫描图像显示中间楔形骨的足底脱位。内侧楔形文字半脱位。对中间楔形文字行切开复位内固定。在六个月的随访中，患者没有投诉，并且能够进行日常工作。在22个月的对照中，在X射线中未观察到清醒或关节炎变化。足底中楔形物脱位很少见，诊断晚可导致效果不佳。这种情况是为了强调考虑这种罕见的损伤的重要性，并在必要时使用先进的影像学研究，考虑到损伤的机制。
