Myerson M S, Quill G
Union Memorial Hospital Foot and Ankle Center, Johns Hopkins University, Baltimore, MD 21218.
Clin Orthop Relat Res. 1991 Jul(268):84-95.
An arthroscopic technique and an open technique with malleolar ostectomy for ankle arthrodesis is described and compared. Internal fixation with compression across the tibiotalar joint was utilized for both methods using either 6.5-mm or 7.0-mm cannulated screws. The indications, advantages, results, and complications of these two fusion techniques in 33 patients are reported. Arthroscopic arthrodesis was performed in 17 patients, using open arthrotomy and malleolar ostectomy in 16. The mean time to arthrodesis for patients having the procedure arthroscopically was 8.7 weeks (range, six to 14 weeks), compared to 14.5 weeks in the open arthrotomy group (range, eight to 26 weeks; p less than 0.004). Despite differences in patient selection for each of the two groups, it was concluded that disabling ankle arthritis for certain patients may be more appropriately managed with arthroscopic arthrodesis than by arthrotomy and malleolar ostectomy, utilizing similar methods of internal fixation.
本文描述并比较了一种用于踝关节融合术的关节镜技术和一种采用踝关节截骨术的开放技术。两种方法均采用经胫距关节加压内固定，使用6.5毫米或7.0毫米空心螺钉。报告了这两种融合技术在33例患者中的适应证、优点、结果及并发症。17例患者接受了关节镜下关节融合术，16例采用开放关节切开术及踝关节截骨术。关节镜手术患者达到融合的平均时间为8.7周（范围6至14周），而开放关节切开术组为14.5周（范围8至26周；p<0.004）。尽管两组患者选择存在差异，但得出结论：对于某些患者，采用相似的内固定方法，关节镜下关节融合术比关节切开术及踝关节截骨术更适合治疗致残性踝关节关节炎。
