Didomenico Lawrence A, Sann Paul
Department of Surgery, St. Elizabeth Health Center, Youngstown, OH, USA.
J Foot Ankle Surg. 2011 Sep-Oct;50(5):626-9. doi: 10.1053/j.jfas.2011.05.007. Epub 2011 Jul 7.
Tibiotalocalcaneal arthrodesis is a successful treatment for patients with severe pain and functional disability in the ankle and subtalar joint. Patients with post-traumatic ankle and subtalar joint arthritis, and/or Charcot deformity, often present with compromised skin and soft tissue structures. In the present report, we describe a technique using an anterior ankle arthrodesis locking plate placed posteriorly to obtain hindfoot and ankle fusion. This technique, which uses the well vascularized, thick, posterior soft tissue envelope, provides very good exposure of the articular surfaces for resection and tibiotalocalcaneal fusion. The technique provides a valuable option for patients with compromised skin and soft tissue structures over aspects of the ankle that make other approaches risky and complicated.
胫距跟关节融合术是治疗踝关节和距下关节严重疼痛及功能障碍患者的一种成功方法。创伤后踝关节和距下关节关节炎患者,以及/或夏科氏畸形患者,通常存在皮肤和软组织结构受损的情况。在本报告中,我们描述了一种技术,即通过将前路踝关节融合锁定钢板置于后方来实现后足和踝关节融合。该技术利用血运丰富、厚实的后方软组织包膜,能很好地暴露关节面以便进行切除和胫距跟关节融合。对于踝关节部位皮肤和软组织结构受损,使得其他手术方法具有风险且复杂的患者而言,该技术提供了一种有价值的选择。