Nihal Aneel, Gellman Richard E, Embil John M, Trepman Elly
Southside Health Service District, Logan Hospital, South Brisbane, Queensland, Australia.
Foot Ankle Surg. 2008;14(1):1-10. doi: 10.1016/j.fas.2007.08.004. Epub 2007 Oct 24.
Numerous techniques for ankle arthrodesis have been reported since the original description of compression arthrodesis. From the early 1950s to the mid 1970s, external fixation was the dominant technique utilized. In the late 1970s and 1980s, internal fixation techniques for ankle arthrodesis were developed. In the 1990s, arthroscopic ankle arthrodesis was developed for ankle arthrosis with minimal or no deformity. The open technique is still widely used for ankle arthrosis with major deformity. For complex cases that involve nonunion, extensive bone loss, Charcot arthropathy, or infection, multiplanar external fixation with an Ilizarov device, with or without a bone graft, may achieve successful union. The fusion rate in most of the recently published studies is 85% or greater, and may depend on the presence of infection, deformity, avascular necrosis, and nonunion.
自从加压关节固定术首次被描述以来,已经报道了许多踝关节融合技术。从20世纪50年代初到70年代中期,外固定是主要使用的技术。在20世纪70年代末和80年代,踝关节融合的内固定技术得到了发展。在20世纪90年代,关节镜下踝关节融合术被开发用于治疗轻度或无畸形的踝关节病。开放技术仍然广泛用于治疗有严重畸形的踝关节病。对于涉及骨不连、大量骨质流失、夏科氏关节病或感染的复杂病例,使用或不使用骨移植的伊利扎罗夫装置进行多平面外固定可能会实现成功融合。在最近发表的大多数研究中,融合率为85%或更高,并且可能取决于是否存在感染、畸形、缺血性坏死和骨不连。