İzole medial subtalar çıkık: Olgu sunumu ve güncel literatürün gözden geçirilmesi

Year 2020, , 559 - 563, 25.12.2020

Emrah Kovalak , İbrahim Yıldız Tolga Atay , Salih Korkmaz Hüseyin Yorgancıgil , Hasan Basri Pınar

https://doi.org/10.17343/sdutfd.317127

Abstract

Giriş:

Akut subtalar eklem çıkıkları,
talokalkaneal ve talonaviküler eklemlerin eş zamanlı oluşan çıkıkları olup
travmatolojinin nadir vakalarıdır. Genellikle yüksek enerjili travmalar
neticesinde oluşan bu kırıklara yüksek oranda ayak bileğinde yumuşak doku
yaralanması ve kırık eşlik etmektedir. İzole medial subtalar çıkıklar ise çok
nadirdir.

Olgu
sunumu:

Bu vaka sunumu ile 32 yaşında yüksekten
düşme sonucu acil servise başvuran erkek hastayı sunduk. Yapılan fizik muayene
ve radyografik tetkikler neticesinde sol ayak bileğinde izole medial subtalar
çıkık tespit edildi. Acil serviste sedasyon altında kapalı redüksiyon yapılarak
atele alındı ve 24 saat dolaşım takibi sonrası taburcu edildi. Üç hafta sonunda
rehabilitasyona başlandı. 3 haftalık rehabilitasyon sonrası kısmi yük verildi.
Sekiz hafta sonunda tam yüke geçildi. On sekiz ayın sonunda hasta semptomsuz
idi. 

Tartışma:

Subtalar çıkıklar travmatolojinin acil vakalarıdır.
Medial çıkıklar inversiyondaki ayağın daha instabil olması nedeni ile daha
sıktır.  Redüksiyon mümkün olan en kısa
sürede sağlanmalıdır. Ek kemik ve yumuşak doku patolojilerinin eşlik etmediği,
erken redüksiyonun sağlandığı izole medial subtalar çıkıklarda uzun dönem
fonksiyonel sonuçları mükemmeldir.

Keywords

Çıkık, travma, subtalar eklem, talus, talotarsal eklem

Isolated medial subtalar dislocation: A case report and a review of the current literature

Abstract

Introduction:

Acute
subtalar joint dislocations are simultaneous dislocations of talocalcaneal and
talonavicular joints with a rare incidence in traumatology. These fractures
usually occur as a result of high-energy traumas and are accompanied in high numbers
by soft tissue injuries and ankle fractures. However, isolated medial
sub-dislocations are very rare.

Case Presentation:

In this
case report, we present a 32-year-old male patient who applied to the emergency
service after falling from a height. Physical and radiographic examinations
revealed an isolated medial subtalar dislocation in the left ankle. The patient
underwent closed reduction under sedation in the emergency service and was
discharged after 24 hours of follow-up. Three weeks later, rehabilitation was
started. After 3 weeks of rehabilitation, the patient was started with partial
weight bearing and switched to full weight bearing after eight weeks. At the
end of 18 months, the patient did not present with any symptoms.

Discussion:

Subtalar
dislocations are emergency cases of traumatology. Medial dislocations are more
frequently seen due to the instability caused by the inversion of the foot. Reduction
should be provided as soon as possible. In the treatment of isolated medial
subdural dislocations, immediate reduction offers excellent long-term
functional outcomes particularly in cases that are not accompanied by additional
bone and soft tissue pathologies.

Keywords

Dislocation, trauma, subtalar joint, talus, talotarsal joint

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