Department of Orthopaedics and Traumatology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1394-8. doi: 10.1007/s00167-011-1459-3. Epub 2011 Mar 1.
This study presents the short-term follow-up results from our case series of patients with posteriorly localized intraosseous talar cysts. Patients were treated via hindfoot endoscopy in the prone position.
We evaluated six ankles of five patients treated with hindfoot endoscopy for intraosseous cysts localized to the posterior portion of talus. Three patients were men and two were women. The median age of the patients was 34 (22-40) years. The bilateral case was treated with a sole operation. The median preoperative AOFAS score was 69 (38-72) points. Additionally, all patients were found to have flexor hallucis longus (FHL) tendinitis in clinical and radiologic evaluations; large os trigoni were detected in five affected ankles. Debridement of scar tissue and FHL tendinitis, resection of os trigoni, and curettage and grafting of the cysts were completed endoscopically with one surgery. The cavities were filled with autografts in all patients except one. Hydroxyapatite was used in one case. The pathologic diagnoses were intraosseous ganglia in three feet and simple bone cysts in the remainder. The preoperative diagnoses were unchanged postoperatively.
The median postoperative follow-up was 27 (12-74) months. In all patients, graft union was confirmed with computed tomography. The median AOFAS score improved to 90 (75-100) points postoperatively. There were no complications. All patients were satisfied with their results.
Hindfoot endoscopy can be used for the treatment of intraosseous talar cysts that are posteriorly localized. Significant advantages of this method include lower morbidity and shorter postoperative hospitalization time. Hindfoot endoscopy is a safe and effective method for treating talar cystic lesions and is an attractive option for experienced arthroscopic surgeons.
IV.
本研究报告了我们一组后踝部骨内距骨囊肿患者的短期随访结果。患者在俯卧位下通过后足内镜进行治疗。
我们评估了 5 名患者的 6 个踝关节，这些患者因后踝部骨内囊肿接受了后足内镜治疗。3 名患者为男性，2 名患者为女性。患者的中位年龄为 34 岁（22-40 岁）。双侧病例仅行单足手术。术前 AOFAS 评分为 69 分（38-72 分）。此外，所有患者在临床和影像学评估中均发现有屈肌肌腱炎；5 个受累踝关节均发现大距骨三角骨。通过单一手术完成了内镜下的瘢痕组织和屈肌肌腱炎清创、距骨三角骨切除、囊肿刮除和植骨。除 1 例患者外，所有患者的空腔均用自体移植物填充。1 例使用了羟基磷灰石。病理诊断为 3 例骨内神经节瘤，其余为单纯骨囊肿。术后诊断与术前相同。
中位随访时间为 27 个月（12-74 个月）。所有患者的 CT 均证实植骨融合。术后 AOFAS 评分为 90 分（75-100 分）。无并发症。所有患者对结果均满意。
后足内镜可用于治疗后踝部骨内囊肿。该方法的显著优势包括较低的发病率和较短的术后住院时间。后足内镜是治疗距骨囊性病变的一种安全有效的方法，对于有经验的关节镜外科医生来说是一种有吸引力的选择。
IV 级。
