Martín Oliva Xavier, Falcão Pedro, Fernandes Cerqueira Raul, Rodrigues-Pinto Ricardo
Orthopaedic Surgeon, Department of Orthopaedics, Clinica del Remei, Barcelona, Spain; Professor, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Orthopaedic Surgeon, Department of Orthopaedics, Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, Lisbon, Portugal.
J Foot Ankle Surg. 2017 May-Jun;56(3):543-546. doi: 10.1053/j.jfas.2017.01.021. Epub 2017 Mar 8.
Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or post-traumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated. The fusion rate was 94% (mean time to fusion 9.8 weeks). Modified American Orthopaedic Foot and Ankle Society ankle-hindfoot scale score (maximum 94 points) improved significantly from 43 to 80 points and the visual analog scale for pain score improved from 7.6 to 1.2. The 12-item short-form physical and mental scores at the last follow-up point were 52.5 and 56.4, respectively. One (5.3%) patient underwent open repeat fusion for nonunion, 2 (10.5%) patients required a second procedure for implant removal, and 1 (5.3%) experienced reversible neuropraxia. In conclusion, posterior arthroscopic subtalar arthrodesis is a safe technique with a good union rate and a small number of complications in patients with no or very little hindfoot deformity.
关节镜下距下关节融合术近来在治疗原发性距下关节或创伤后关节炎、联合畸形或伴有距下关节炎的炎性疾病中颇受青睐。本研究报告了19例（19足）患者接受经两个后外侧入路的关节镜下距下关节融合术的临床及影像学结果。前瞻性评估了总共19例经后外侧入路的关节镜下距下关节融合术（最短随访24个月），这些手术均未植骨且使用了2枚平行螺钉。融合率为94%（平均融合时间9.8周）。美国矫形足踝协会改良踝关节-后足评分（满分94分）从43分显著提高至80分，视觉模拟疼痛评分从7.6分改善至1.2分。末次随访时12项简明身体和精神评分分别为52.5和56.4。1例（5.3%）患者因骨不连接受了切开翻修融合术，2例（10.5%）患者因取出植入物需要二次手术，1例（5.3%）出现可逆性神经失用。总之，对于后足畸形无或极少的患者，后外侧入路关节镜下距下关节融合术是一种安全的技术，融合率良好，并发症较少。
