Kim Hyong Nyun, Kim Gab Lae, Park Jae Yong, Woo Kyung Jei, Park Yong Wook
Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
J Foot Ankle Surg. 2013 May-Jun;52(3):402-5. doi: 10.1053/j.jfas.2012.12.018. Epub 2013 Jan 30.
Fixation of a large osteochondral fragment on the posteromedial talus can be performed using medial malleolar osteotomy or an arthroscopic technique with a transmalleolar portal. However, osteotomy can be associated with some morbidity, such as longstanding pain and tenderness at the osteotomy site. Also, it requires longer immobilization. However, the transmalleolar portal damages the tibial articular cartilage, which can later cause pain. In young patients, it can injure the epiphyseal plate. We describe a posterior arthroscopic technique using 3 posterior portals that allow access to a posteromedial osteochondral lesion of the talus and fixation of the osteochondral fragment without malleolar osteotomy or transmalleolar drilling.
使用内踝截骨术或经踝关节镜技术并通过跨踝关节入口，可以对距骨后内侧的大块骨软骨碎片进行固定。然而，截骨术可能会带来一些并发症，比如截骨部位长期疼痛和压痛。此外，它需要更长时间的固定。不过，经踝关节入口会损伤胫骨关节软骨，这随后可能导致疼痛。在年轻患者中，它还可能损伤骨骺板。我们描述了一种后入路关节镜技术，该技术使用3个后外侧入口，可进入距骨后内侧骨软骨损伤部位，并在不进行内踝截骨术或跨踝关节钻孔的情况下固定骨软骨碎片。
