特発性距骨無腐性壊死の2症例

概要

論文の詳細を見る
Aseptic necrosis of the talus usually occurs following fracture or dislocation of the talus, but here we report on two cases of idiopathic aseptic necrosis of the talus.Case 1, a 44 year-old woman with hyperuricemia had right ankle pain. Roentgenograms revealed collapse of the talus with severe osteoarthritis of the right ankle joint. Talectomy with calcaneo-crural arthrodesis was carried out. Postoperatively she had no problem in ADL except occasional mild pain in the midtarsal joint.Case 2, a 35 year-old woman who had no preceding cause of osteonecrosis. However, roentgenograms showed sclerosis of the right talus, but no osteoarthritic change and collapse were found. She was advised to use a patellar-tendon-bearing brace, which she used for 19 months. At follow-up, 4 years and 2 months later, her ankle roentgenogram showed a shight worsening of the sclerosis and collapse, but no osteoarthritis. The range of motion of her ankle was good, and she had no ankle pain.From our study we think that conservative treatment should be carried out prior to surgical treatment in aseptic necrosis of the talus, if collapse of the talus and osteoarthritis of the ankle are minor.
西日本整形・災害外科学会の論文