Walther M, Hörterer H, Harrasser N, Röser A, Gottschalk O
Schön Klinik München Harlaching - FIFA Medical Centre of Excellence, Harlachinger Straße 51, 81547, München, Deutschland.
Orthopade. 2020 Nov;49(11):962-967. doi: 10.1007/s00132-020-03990-w.
Minimally invasive medializing calcaneal osteotomy, the implantation of a tarsi spacer and the tendoscopy of the posterior tibial tendon have been established as treatment options for tibialis posterior insufficiency grade II. The minimally invasive medializing calcaneal osteotomy allows a correction of the hindfoot valgus like an open procedure with a significantly lower risk of wound healing problems. It has gained increasing popularity within recent years. There is also good evidence for arthroereisis, with the use of the sinus tarsi spacer being primarily an addition to calcaneus sliding osteotomy. The possibilities for tendoscopy of the posterior tibial tendon are limited to debridement and synovectomy. Various papers report minimally invasive alternatives to the strayer procedure for a shortened gastrocnemius muscle. The proximal lengthening of the medial head of the gastrocnemius muscle is particularly popular as a soft tissue-sparing, less traumatic procedure. So far, no reports of a minimally invasive cotton osteotomy have been found in the literature.
微创内侧移位跟骨截骨术、跗骨间隔植入术以及胫后肌腱关节镜检查已被确立为治疗Ⅱ级胫后肌功能不全的治疗选择。微创内侧移位跟骨截骨术能够像开放手术一样矫正后足外翻，且伤口愈合问题风险显著更低。近年来，它越来越受欢迎。关节制动也有充分的证据支持，跗骨窦间隔植入主要是跟骨滑动截骨术的辅助手段。胫后肌腱关节镜检查的操作仅限于清创和滑膜切除术。各种文献报道了针对腓肠肌缩短的Strayer手术的微创替代方法。腓肠肌内侧头近端延长术作为一种保留软组织、创伤较小的手术尤其受欢迎。到目前为止，文献中尚未发现关于微创棉塞截骨术的报道。
