Oznur Ali, Roukis Thomas S
Department of Orthopaedics and Traumatology, Hacettepe University, Sihhiye, Ankara, Turkey.
Clin Podiatr Med Surg. 2008 Oct;25(4):609-22, viii. doi: 10.1016/j.cpm.2008.05.008.
Ray resection for localized necrosis, infection, and osteomyelitis is an accepted procedure allowing removal of the diseased toe and metatarsal. The traditional approach involves a rather lengthy incision and dissection that can compromise the vascular supply to the remaining forefoot. The use of minimum incision techniques to perform metatarsal ray resection as presented here represents a simple, reliable, and easily reproduced procedure that limits soft-tissue dissection and the associated wound healing-related complications inherent to the traditional approach. Following minimum incision metatarsal ray resection, the resultant defect from the toe amputation can be primarily closed, covered with a split-thickness skin graft, or closed in delayed primary fashion with the use of a mini-external fixation device. The authors present the proper indications and a step-by-step guide for performing minimum incision metatarsal ray resection with and without the supplemental use of mini-external fixation to close the soft-tissue defect about the toe amputation site.
针对局限性坏死、感染和骨髓炎进行的射线切除术是一种公认的手术方法，可切除患病的脚趾和跖骨。传统方法需要相当长的切口和解剖操作，这可能会损害剩余前足的血供。本文介绍的使用最小切口技术进行跖骨射线切除术是一种简单、可靠且易于重复的手术，它限制了软组织解剖以及传统方法固有的与伤口愈合相关的并发症。在进行最小切口跖骨射线切除术后，脚趾截肢造成的缺损可直接缝合、用中厚皮片覆盖，或使用小型外固定装置以延迟一期缝合的方式闭合。作者介绍了进行最小切口跖骨射线切除术的适当适应症以及分步指南，包括是否补充使用小型外固定装置来闭合脚趾截肢部位周围的软组织缺损。
