Successful operative treatment of neglected pure Chopart joint dislocation: two case reports and literature review

Draško Vasović; Lazar Mičeta; Filip Čučaković; Aleksandar Jevtić; Danilo Jeremić; Nemanja Slavković

doi:10.2298/VSP240206017V

Draško Vasović Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia
Lazar Mičeta Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia
Filip Čučaković Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia
Aleksandar Jevtić Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia
Danilo Jeremić Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia; †University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Nemanja Slavković Institute for Orthopedic Surgery “Banjica”, Belgrade, Serbia; †University of Belgrade, Faculty of Medicine, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP240206017V

Keywords: zglob, iščašenja;, ortopedske procedure;, tarzalni zglob;, lečenje, odlaganje;, lečenje, ishod.

Abstract

Uvod. Dislokacija Šopartovog zgloba (DŠZ) predstavlja retku povredu, inicijalno često neprepoznatu. Najpre zbog toga, ali i zbog povišenog morbiditeta do kojih dovodi, kao i zbog loših ishoda lečenja, ta povreda predstavlja značajan klinički problem. Prikaz bolesnika. Prikazana su dva slučaja previđene DŠZ kod bolesnika primljenih u našu ustanovu tokom jedne godine. Prvi slučaj je bio muškarac star 63 godine, povređen prilikom pada niz stepenice, dok je drugi slučaj bila žena stara 33 godine, povređena u saobraćajnom udesu. Oba bolesnika su u početku lečena pod dijagnozom distorzije stopala i skočnog zgloba. Po prijemu u ustanovu, nakon sprovedene dijagnostike kompjuterizovanom tomografijom, kod oba bolesnika konstatovano je postojanje previđene čiste DŠZ. Oba bolesnika su hirurški lečena otvorenom repozicijom i unutrašnjom fiksacijom Šopartovog zgloba pomoću K-igala. Šest nedelja nakon operacije, K-igle su uklonjene, primenjena je potkolena ortoza za hodanje, uz dopušten delimičan oslonac na operisanu nogu i sa postepenim povećanjem do punog oslanjanja u narednih šest nedelja. Započeta je fizikalna terapija. Nakon šestomesečnog praćenja, oba bolesnika su bila uspešno rehabilitovana, dostigavši konačni American Orthopaedic Foot and Ankle Society skor od 76/100 za bolesnicu i 84/100 za bolesnika. Zaključak. Uprkos kasnom postavljanju dijagnoze i odloženom operativnom lečenju, funkcionalni ishodi bolesnika sa čistim DŠZ, lečenih otvorenom repozicijom i perkutanom fiksacijom pomoću K-igala, mogu biti zadovoljavajući. Potrebne su dodatne studije da bi se stekao bolji uvid u prevalenciju i uzročne faktore mogućih komplikacija ovakvog pristupa lečenju navedene povrede.

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