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关节镜下治疗儿童距跟骨桥

Arthroscopic treatment of calcaneonavicular coalition in children.

机构信息

Pediatric Orthopedic and Traumatologic Surgery Department, Children's Hospital, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.

出版信息

Orthop Traumatol Surg Res. 2011 Sep;97(5):565-8. doi: 10.1016/j.otsr.2011.03.017. Epub 2011 Jun 22.

Abstract

Calcaneonavicular coalition is a common source of pain and more or less severe flat and stiff foot in children. Classically, treatment consists in resecting the coalition using a dorsolateral approach. Good quality resection and interposition can prevent recurrence. The most common complications are infection, hematoma and neuroma. Arthroscopy offers a minimally invasive alternative, but the optimal approach remains undetermined. We describe a surgical technique with an approach based on the anterolateral process of the calcaneus, in three cases with 12 months' follow-up. Arthroscopic resection has certain advantages: recovery is quicker, and the esthetic result is better. For the instrumental portal, skin incision should be superficial, followed by blunt dissection of subcutaneous tissue to avoid superficial peroneal nerve injury. Although longer term follow-up is needed, arthroscopy seems to be an attractive minimally invasive technique in this kind of pathology.

摘要

跟舟骰骨联合是儿童常见的疼痛来源,或多或少会导致平足和僵硬。传统上,治疗方法是通过外侧入路切除联合。高质量的切除和间置可以预防复发。最常见的并发症是感染、血肿和神经瘤。关节镜检查提供了一种微创的替代方法,但最佳方法仍未确定。我们描述了一种基于跟骨前外侧突的手术技术,在三个病例中进行了 12 个月的随访。关节镜下切除有一定的优势:恢复更快,美容效果更好。对于仪器通道,皮肤切口应较浅,然后钝性分离皮下组织,以避免腓浅神经损伤。虽然需要更长时间的随访,但关节镜检查似乎是这种病理情况下一种有吸引力的微创技术。

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