Paley Dror, Lamm Bradley M, Purohit Rachana M, Specht Stacy C
International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
Foot Ankle Clin. 2008 Sep;13(3):471-84, ix. doi: 10.1016/j.fcl.2008.05.001.
Ankle joint distraction has been shown to be a viable alternative to ankle arthrodesis or ankle replacement. The à la carte approach to ankle joint preservation (resection of blocking osteophytes, release of muscle/joint contractures, and realignment osseous ankle procedures) presented in this article as important for a successful outcome as is the hinged ankle joint distraction technique itself. The authors reviewed 32 patients who underwent this ankle joint distraction technique and found 78% of patients had maintained their ankle range of motion and have no pain to occasional moderate pain that can be managed generally with nonsteroidal anti-inflammatory drugs alone. Only one has required an ankle fusion, and only one has been converted to an ankle joint replacement. The longevity of these results and the higher percent of good or excellent results when compared with other studies suggest that combining adjunctive procedures and articulation with ankle distraction improves the results of this procedure.
踝关节撑开术已被证明是踝关节融合术或踝关节置换术的一种可行替代方案。本文介绍的踝关节保留的“点菜式”方法（切除阻挡性骨赘、松解肌肉/关节挛缩以及进行踝关节骨性重新排列手术）对于取得成功结果而言与铰链式踝关节撑开技术本身同样重要。作者回顾了32例行这种踝关节撑开技术的患者，发现78%的患者保持了踝关节活动范围，且没有疼痛至偶尔有中度疼痛，一般仅用非甾体类抗炎药即可控制。仅1例需要进行踝关节融合，仅1例已转为踝关节置换。与其他研究相比，这些结果的持久性以及较高比例的良好或优异结果表明，将辅助手术和关节活动与踝关节撑开相结合可改善该手术的效果。
