Dehoust W, Schmidt H G
Berufsgenossenschaftliches Unfallkrankenhaus Hamburg.
Aktuelle Traumatol. 1989 Aug;19(4):156-61.
Arthrodesis may be mandatory after destruction or painful arthrosis of the ankle joint. The time at which this should be performed, as well as the technique to be employed, are both judged differently by various writers. We used exclusively the fixateur externe for stabilisation with 44 arthrodeses of the ankle joint, since this ensures stability during exercise and partial load. The complications recorded were two aseptic necroses of the talus and dysostosis in two cases which required corrective surgery. The results obtained by use lead us to the following conclusions: More than one-half of the examined subjects wore the orthopaedic made-to-measure shoes for longer than one year compensating the leg shortening by an average of 1.0 cm. The intraoperatively attempted repositioning of the talus in relation to the axis of the tibia tended to have a rather negative effect in our patients. The at least equal long-term results of early and late arthrodeses indicate that early arthrodeses are preferable, seeing that 55.8% of the followed-up persons were able to resume their professional activities relatively quickly.
在踝关节遭到破坏或出现疼痛性关节病后，关节融合术可能是必要的。不同作者对于实施该手术的时机以及所采用的技术的判断各不相同。我们仅使用外固定器对44例踝关节进行融合以实现稳定，因为这可确保在运动和部分负重期间的稳定性。记录的并发症包括两例距骨无菌性坏死以及两例骨发育异常，后者需要进行矫正手术。使用外固定器所获得的结果使我们得出以下结论：超过一半的受检对象穿着定制的矫形鞋超过一年，平均代偿腿部缩短1.0厘米。在我们的患者中，术中尝试使距骨相对于胫骨轴线重新定位往往会产生相当负面的影响。早期和晚期关节融合术至少具有同等的长期效果，这表明早期关节融合术更可取，因为55.8%的随访者能够相对较快地恢复其职业活动。
