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关节镜下三关节和改良双后足关节融合术

Arthroscopic triple and modified double hindfoot arthrodesis.

作者信息

Jagodzinski N A, Parsons A M J, Parsons S W

机构信息

The Royal Cornwall Hospital, Truro, United Kingdom.

The Royal Cornwall Hospital, Truro, United Kingdom.

出版信息

Foot Ankle Surg. 2015 Jun;21(2):97-102. doi: 10.1016/j.fas.2014.10.001. Epub 2014 Oct 25.

Abstract

BACKGROUND

Arthroscopic arthrodesis is an accepted technique for the ankle but less commonly reported for multiple hindfoot joints. We present a case series review to establish the feasibility of this surgery.

METHODS

In a consecutive series of 112 arthroscopic hindfoot arthrodeses, 18 involved decortication and fusion of 2 or 3 hindfoot joints. These were reviewed to identify complications, union rates and improvement over preoperative state.

RESULTS

Mean age was 62 (45-78). Mean follow-up was 4.4 (1.75-7.5) years. There were no perioperative complications. The four patients with triple fusions united with good or excellent outcomes. Of 14 patients with subtalar and talonavicular arthrodeses there were three talonavicular non-unions.

CONCLUSIONS

Arthroscopic double and triple arthrodeses appear feasible salvage options for pain and deformity. Decortication of all three joints and rotatory correction of deformity is possible whilst preserving the soft tissue envelope. Late adjacent joint pain and arthrosis can occur.

摘要

背景

关节镜下关节融合术是治疗踝关节的一种公认技术,但在后足多关节的应用报道较少。我们通过病例系列回顾来确定该手术的可行性。

方法

在连续的112例关节镜下后足关节融合术中,18例涉及2个或3个后足关节的去皮质和融合。对这些病例进行回顾,以确定并发症、融合率以及与术前状态相比的改善情况。

结果

平均年龄为62岁(45 - 78岁)。平均随访时间为4.4年(1.75 - 7.5年)。无围手术期并发症。4例三关节融合患者均获得良好或优秀的融合效果。在14例距下关节和距舟关节融合患者中,有3例距舟关节未融合。

结论

关节镜下双关节和三关节融合术对于疼痛和畸形似乎是可行的挽救性选择。在保留软组织包膜的同时,可以对所有三个关节进行去皮质和对畸形进行旋转矫正。可能会出现晚期相邻关节疼痛和关节炎

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