Allegra Francesco, Maffulli Nicola, Cerza Fabio, Delianni Emanuele
Department of Orthopaedic, Università La Sapienza, Polo Pontino, Latina, Italy.
Sports Med Arthrosc Rev. 2009 Sep;17(3):185-9. doi: 10.1097/JSA.0b013e3181b12745.
Standard arthroscopy of the ankle does not allow to approach at the same time the anterior and posterior compartments. Keeping the patient supine and with the application of judicious traction, anterior ankle arthroscopy allows to examine the various intra-articular structures, but treat is limited only to anterior pathology. Also, it is not possible to explore posterior compartment and posterior hindfoot through an anterior approach. Normally, for those patients in whom both the anterior and posterior compartments were to be operated upon, surgery is stopped, and the patient has to be re-positioned. We describe a 2 postero-medial hindfoot portals procedure, which allows to reach both the posterior aspect of the ankle joint and the extra-articular compartment of the hindfoot keeping the patient supine throughout the procedure. After arthroscopy of the anterior compartment using standard anterior portals, 2 postero-medial endoscopic approaches make it possible to visualize and treat pathologies of the posterior ankle and of the hindfoot, without prolonging the operation through the need to reposition the patient in the prone position.
标准的踝关节镜检查无法同时进入前侧和后侧间隙。患者保持仰卧位并施加适当牵引时，前路踝关节镜检查可用于检查各种关节内结构，但治疗仅限于前部病变。此外，通过前路无法探查后侧间隙和后足。通常，对于那些需要同时对前侧和后侧间隙进行手术的患者，手术会暂停，患者必须重新摆放体位。我们描述了一种双后内侧后足入路手术，该手术可在患者全程保持仰卧位的情况下，同时到达踝关节后侧和后足的关节外间隙。使用标准前侧入路对前侧间隙进行关节镜检查后，两个后内侧内镜入路可使可视化并治疗后踝和后足的病变，而无需因将患者重新摆放为俯卧位而延长手术时间。
