Sowa D T, Krackow K A
Johns Hopkins University School of Medicine, Department of Orthopaedic Surgery, Baltimore.
Foot Ankle. 1989 Apr;9(5):232-40. doi: 10.1177/107110078900900505.
A new technique of tibiotalar arthrodesis has been developed offering wide exposure, excellent correction of deformity, good bony apposition, and blade plate fixation. This technique has even been effective in cases of ischemic necrosis of the talus. A modified pediatric blade plate is used to effect compression of the talus to the tibia and to provide stability against flexion/extension and varus/valgus movement. Fixation is augmented by a lateral fibular struct screwed to the tibia and talus. In this series, 17 compression blade plate tibiotalar arthrodeses were performed. Follow-up averaged 48 months (range 13 to 85 months). Preoperative diagnoses included postraumatic degenerative arthritis, rheumatoid arthritis, and ischemic necrosis of the talus. Solid fusion was achieved in 16 of 17 patients (94%) with a painless, stable pseudarthrosis in the remaining one. Time to fusion averaged 4 months (range 2 1/2 to 6 months). Functional clinical results were excellent in 12 and good in 4 patients. Of 14 patients evaluated by the Mazur scale, 10 scored within the range of excellent; 2, good; and 2, fair.
一种新的胫距关节融合技术已经研发出来，该技术具有暴露充分、畸形矫正良好、骨对合佳以及钢板固定等优点。这项技术甚至在距骨缺血性坏死的病例中也有效。使用一种改良的儿童钢板来实现距骨对胫骨的加压，并提供抵抗屈伸和内翻/外翻运动的稳定性。通过将外侧腓骨结构拧到胫骨和距骨上来增强固定。在该系列中，共进行了17例加压钢板胫距关节融合术。随访平均48个月（范围为13至85个月）。术前诊断包括创伤后退行性关节炎、类风湿性关节炎和距骨缺血性坏死。17例患者中有16例（94%）实现了牢固融合，其余1例形成无痛、稳定的假关节。融合时间平均为4个月（范围为2.5至6个月）。12例患者的功能临床结果为优，4例为良。在通过Mazur量表评估的14例患者中，10例评分在优的范围内；2例为良；2例为中。
