Ismavel Ravichand, Azad Sait S, Viju Daniel V, Daniel Alfred J
Associate Professor, Department of Orthopaedics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Postgraduate Registrar, Department of Orthopaedics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
J Foot Ankle Surg. 2014 Jul-Aug;53(4):511-4. doi: 10.1053/j.jfas.2014.02.010. Epub 2014 Apr 6.
Tibiocalcaneal arthrodesis has been a salvage option for conditions with extensive loss of the talar body. In conditions that preclude the use of internal fixation, external compression arthrodesis has been the preferred technique to achieve fusion about the hindfoot. Since Sir John Charnley elucidated the technique of compression arthrodesis using compression clamps, various modifications and techniques of external compression arthrodesis have been described. Various clinical and biomechanical studies have established the superiority of triangular transfixation in external compression arthrodesis. We have described a simple technique of compression arthrodesis after the principle of triangular transfixation using easily available hardware from Ilizarov instrumentation. This technique is relatively inexpensive in terms of the cost of the materials, uses a modular construct, and allows multiplanar correction of the hindfoot. It can be used intraoperatively to distract the hindfoot joints, especially in the presence of fibrosis and poor skin conditions. We believe this device can be a reasonable alternative to the conventional external fixation techniques for tibiocalcaneal arthrodesis.
对于距骨体广泛缺失的情况,胫跟关节融合术一直是一种挽救性选择。在无法使用内固定的情况下,外加压关节融合术一直是实现后足融合的首选技术。自从约翰·查恩利爵士阐明了使用加压夹进行加压关节融合术的技术以来,已经描述了各种外加压关节融合术的改良方法和技术。各种临床和生物力学研究已经证实了外加压关节融合术中三角贯穿固定的优越性。我们描述了一种基于三角贯穿固定原则的加压关节融合术的简单技术,使用来自伊里扎洛夫器械的易于获得的硬件。就材料成本而言,该技术相对便宜,采用模块化结构,并允许对后足进行多平面矫正。它可在术中用于牵开后足关节,尤其是在存在纤维化和皮肤状况较差的情况下。我们认为,对于胫跟关节融合术,这种装置可以成为传统外固定技术的合理替代方案。