Department of Orthopaedic Surgery, Kantonsspital Liestal, Liestal, Switzerland.
Foot Ankle Int. 2011 Nov;32(11):1023-31. doi: 10.3113/FAI.2011.1023.
Supramalleolar osteotomies are increasingly popular for addressing asymmetric arthritis of the ankle joint. Still, recommendations for the indication and the use of additional procedures remain arbitrary. We preoperatively grouped different types of asymmetric arthritis into several classes and assessed the usefulness of an algorithm based on these classifications for determining the choice of supramalleolar operative procedure and the risk factors for treatment failure.
Ninety-two patients (94 ankles) were followed prospectively and assessed clinically and radiographically 43 months after a supramalleolar osteotomy for asymmetric arthritis of the ankle joint.
Significant improvement of the clinical scores was found. Postoperative reduction of radiological signs of arthritis was observed in mid-stage arthritis. Age and gender did not affect the outcome. Ten ankles failed to respond to the treatment and were converted to total ankle replacements or fused.
Supramalleolar osteotomies can be effective for the treatment of early and midstage asymmetric arthritis of the ankle joint. However, certain subgroups have a tendency towards a worse outcome and may require additional surgery. Therefore preoperative distinction of different subgroups is helpful for determination of additional procedures.
距下骨切开术越来越多地用于治疗踝关节不对称性关节炎。然而，对于适应证和附加手术的使用建议仍然是任意的。我们术前将不同类型的不对称性关节炎分为几类，并评估基于这些分类的算法在确定距下骨手术选择和治疗失败的风险因素方面的有用性。
92 例（94 足）患者前瞻性随访，距下骨切开术治疗踝关节不对称性关节炎 43 个月后进行临床和影像学评估。
发现临床评分显著改善。中晚期关节炎患者术后关节炎的放射学征象减轻。年龄和性别对结果无影响。10 个踝关节对治疗反应不佳，转为全踝关节置换或融合。
距下骨切开术可有效治疗踝关节早期和中期的不对称性关节炎。然而，某些亚组有更差的预后倾向，可能需要额外的手术。因此，术前区分不同的亚组有助于确定附加手术。
