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技术文章:采用双切口入路,经克氏针穿过距下关节行跗骨联合切除术

Technique Article: Tarsal Coalition Resection Using Kirschner Wires Across the Subtalar Joint in a Two-Incision Approach.

作者信息

Edmonds W Bentley, Wiley Kevin, Panas Kenton

机构信息

Surgeon, McBride Orthopedic Hospital, Oklahoma City, OK.

Resident Physician, Department of Orthopedics, University of Oklahoma, Oklahoma City, OK.

出版信息

J Foot Ankle Surg. 2019 Mar;58(2):337-340. doi: 10.1053/j.jfas.2018.08.056.

Abstract

Subtalar coalitions are a significant cause of morbidity, especially in the pediatric population. Arthrodesis was considered the standard of care, with coalitions involving >50% of the joint until the mid-1990s. Today, some are recommending resection of the coalition first and to save hindfoot arthrodesis as a salvage procedure. As a result, resection of talocalcaneal coalitions is becoming more common, and optimizing the surgical technique is a necessity in the field of orthopedics. We present a technique to optimize surgical resection of talocalcaneal coalitions by using Kirschner wires inserted from the lateral side, which allows us to demarcate the coalition. This gives us a greater ability to perform a more complete resection and also helps prevent iatrogenic trauma to the articulating surface.

摘要

距下关节联合是发病的重要原因,尤其是在儿童群体中。直到20世纪90年代中期,关节融合术一直被视为标准治疗方法,当时关节联合累及超过50%的关节。如今,一些人建议先切除关节联合,将后足关节融合术作为挽救性手术。因此,距下关节联合切除术越来越普遍,在骨科领域优化手术技术是必要的。我们介绍一种通过从外侧插入克氏针来优化距下关节联合手术切除的技术,这使我们能够界定关节联合。这使我们有更大的能力进行更彻底的切除,也有助于防止对关节面造成医源性创伤。

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