Rockett M S, Ng A, Guimet M
Harris County Podiatric Surgical Residency and Fellowship Programs, Greater Texas Education Foundation, Houston, Texas, USA.
Clin Podiatr Med Surg. 2001 Jul;18(3):515-35.
Until there is a total ankle implant developed that stands the test of time, ankle arthrodesis will continue to be the gold standard in the operative treatment of the arthritic ankle joint. Ankle arthrodesis techniques include minimally invasive methods that can be performed via arthroscopy or with miniarthrotomy. Extensile techniques include extra-articular fusions, the transfibular approach, removal of both malleoli, and the Blair fusion. An ankle arthrodesis can be fixated utilizing either internal or external fixation. The form of fixation chosen depends on availability and surgeon preference and/or experience, and most importantly, which is the optimal method for the patient. Although ankle arthrodesis is the mainstay treatment for posttraumatic arthrosis, innovations and technical improvements have resulted in reconstructive alternatives for ankle arthritis, including distraction ankle arthroplasty, supramalleolar osteotomy, and total ankle replacement. Advances in biomaterials and instrumentation have allowed for the evolution of arthrodesis techniques as evidenced by the myriad of techniques reported in the literature.
在出现经得起时间考验的全踝关节植入物之前，踝关节融合术仍将是治疗踝关节关节炎的手术金标准。踝关节融合术技术包括可通过关节镜或小切口关节切开术实施的微创方法。扩展性技术包括关节外融合、经腓骨入路、双踝切除以及布莱尔融合术。踝关节融合术可采用内固定或外固定。选择的固定方式取决于可获得性、外科医生的偏好和/或经验，最重要的是，哪种方法对患者而言是最佳的。尽管踝关节融合术是创伤后关节炎的主要治疗方法，但创新和技术改进已带来了踝关节关节炎的重建替代方案，包括撑开式踝关节成形术、踝上截骨术和全踝关节置换术。生物材料和器械的进步推动了融合术技术的发展，文献中报道的众多技术就是明证。
