Walter R P, Walker R W, Butler M, Parsons S
Royal Cornwall Hospitals NHS Trust, Treliske, Cornwall, UK.
Royal Cornwall Hospitals NHS Trust, Treliske, Cornwall, UK.
Foot Ankle Surg. 2018 Oct;24(5):417-422. doi: 10.1016/j.fas.2017.04.006. Epub 2017 Apr 23.
Subtalar arthrodesis through an open approach carries significant risk of complications. An arthroscopic approach aims to minimise damage to the soft tissue envelope to improve recovery, union and complication rates. A two portal approach through the sinus tarsi was used.
A retrospective review of all patients undergoing isolated arthroscopic arthrodesis was performed.
Seventy-seven procedures were performed. Successful arthrodesis was achieved in 75 (97.4%). Two patients underwent successful revision arthrodesis for aseptic nonunion. There was one (1.3%) superficial infection and one (1.3%) partial sural nerve injury.
Two-portal sinus tarsi arthroscopic subtalar arthrodesis is safe and effective. Advantages over other arthroscopic approaches are the access to all three facets of the joint, avoidance of a posterolateral portal in order to minimise risk to the sural nerve, and the ability to use the same approach to arthrodese the entire triple hindfoot joint complex. Technical tips and pitfalls are discussed.
通过开放入路进行距下关节融合术存在显著的并发症风险。关节镜入路旨在将对软组织包膜的损伤降至最低，以提高恢复、愈合及降低并发症发生率。采用了经跗骨窦的双切口入路。
对所有接受单纯关节镜下关节融合术的患者进行回顾性研究。
共进行了77例手术。75例（97.4%）实现了成功融合。2例患者因无菌性骨不连接受了成功的翻修关节融合术。发生1例（1.3%）浅表感染和1例（1.3%）腓肠神经部分损伤。
双切口跗骨窦关节镜下距下关节融合术安全有效。与其他关节镜入路相比，其优势在于可进入关节的所有三个面，避免后外侧切口以将腓肠神经损伤风险降至最低，以及能够使用相同入路对整个后足三联关节复合体进行关节融合。文中讨论了技术要点和陷阱。
