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创伤后踝关节炎

Post-traumatic ankle arthritis.

作者信息

Weatherall Justin M, Mroczek Kenneth, McLaurin Toni, Ding Bryan, Tejwani Nirmal

出版信息

Bull Hosp Jt Dis (2013). 2013;71(1):104-12.

Abstract

Post-traumatic ankle arthritis can be a very disabling condition especially in young patients. Localization of the pain is important to allow appropriate treatment. Non-surgical treatment options include anti-inflammatory medications and use of bracing. Multiple surgical options range from joint sparing procedures for the younger patient to total ankle replacement for the older, less active patient. Arthrodesis remains the gold standard and is the procedure of choice for younger patients who are heavy laborers and in patients with severe arthritis who are not candidates for a total ankle replacement. Joint sparing operations include allograft resurfacing, arthroscopic debridement and osteophyte resection, joint distraction arthroplasty, and supramalleolar osteotomy. In older low demand patients, the surgeon may consider a total ankle arthroplasty as an alternative to arthrodesis.

摘要

创伤后踝关节关节炎可能是一种非常致残的病症,尤其是在年轻患者中。疼痛的定位对于进行适当的治疗很重要。非手术治疗选择包括抗炎药物和使用支具。多种手术选择范围从针对较年轻患者的保留关节手术到针对年龄较大、活动较少患者的全踝关节置换术。关节融合术仍然是金标准,是年轻体力劳动者以及不适合进行全踝关节置换术的严重关节炎患者的首选手术。保留关节的手术包括同种异体骨表面置换、关节镜下清创和骨赘切除、关节撑开成形术以及踝关节上截骨术。对于年龄较大、需求较低的患者,外科医生可能会考虑将全踝关节置换术作为关节融合术的替代方案。

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