Shnol Helen, LaPorta Guido A
Department of Graduate Medical Education and Podiatric Surgery, Our Lady of Lourdes Memorial Hospital, 169 Riverside Drive, Binghamton, NY 13905, USA.
Department of Graduate Medical Education and Podiatric Surgery, Our Lady of Lourdes Memorial Hospital, 169 Riverside Drive, Binghamton, NY 13905, USA.
Clin Podiatr Med Surg. 2018 Oct;35(4):403-422. doi: 10.1016/j.cpm.2018.06.002. Epub 2018 Aug 14.
Advanced ankle arthritis, avascular osteonecrosis, and osteomyelitis of the ankle remain a surgical challenge in the foot and ankle arena with limited treatment options. Multiple medical comorbidities contribute to total loss of the talus. Collapse of the talar body as a complication of total ankle arthroplasty, talectomy in infection, and septic talus necrosis or severe bone defects caused by tumor resection may result in need for total talar replacement. Ankle arthrodesis and tibiocalcaneal fusion after talectomy can produce severe disability of the ankle and foot. Total ankle replacement is a viable option for treatment of end-stage ankle arthritis in appropriate patient populations.
晚期踝关节关节炎、距骨缺血性坏死和踝关节骨髓炎在足踝领域仍然是手术挑战，治疗选择有限。多种内科合并症会导致距骨完全丧失。距骨体塌陷作为全踝关节置换术的并发症、感染时的距骨切除术、感染性距骨坏死或肿瘤切除导致的严重骨缺损，可能需要进行全距骨置换。距骨切除术后的踝关节融合术和胫跟融合术会导致踝关节和足部严重残疾。对于合适的患者群体，全踝关节置换是治疗终末期踝关节关节炎的可行选择。
