Sekiya Hitoshi, Horii Tomoko, Sugimoto Naoya, Hoshino Yuichi
Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
J Foot Ankle Surg. 2011 Sep-Oct;50(5):589-92. doi: 10.1053/j.jfas.2011.04.021. Epub 2011 Jun 8.
Arthroscopic arthrodesis of the ankle has several advantages compared with open arthrodesis, including a smaller skin incision, less damage to the soft tissue around the joint, a lower risk of skin necrosis and infection, a lower incidence of postoperative infection and swelling, and better preservation of the contour of the surface of the joint, which maintains a larger contact area between the talus and tibia. We successfully performed arthroscopic arthrodesis of the tibiotalocalcaneal joints with intramedullary nails with fins in 9 ankles of 8 patients. Solid fusion was attained in all cases, except for 1 case of nonunion at the subtalar joint. We also corrected the alignment in 1 patient with a varus deformity. The fixation was strong, even in the case of poor bone quality, such as occurs in rheumatoid arthritis. The intramedullary nails with fins allowed for appropriate compression for bone consolidation without loss of rotational stability. Arthroscopic tibiotalocalcaneal arthrodesis, a less-invasive technique than conventional open surgery, is effective treatment, especially in patients with poor skin conditions secondary to diseases such as rheumatoid arthritis and diabetes mellitus.
与开放性关节融合术相比，踝关节镜下关节融合术有几个优点，包括较小的皮肤切口、对关节周围软组织的损伤较小、皮肤坏死和感染风险较低、术后感染和肿胀发生率较低，以及更好地保留关节表面轮廓，从而保持距骨和胫骨之间更大的接触面积。我们成功地对8例患者的9个踝关节采用带鳍髓内钉进行了胫距跟关节镜下关节融合术。除1例距下关节不愈合外，所有病例均实现了牢固融合。我们还矫正了1例有内翻畸形患者的对线。即使在骨质质量较差的情况下，如类风湿关节炎患者，固定也很牢固。带鳍髓内钉可在不损失旋转稳定性的情况下进行适当加压以促进骨愈合。关节镜下胫距跟关节融合术是一种比传统开放手术侵入性更小的技术，是一种有效的治疗方法，尤其适用于类风湿关节炎和糖尿病等疾病继发皮肤状况较差的患者。
