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创伤后踝与后足骨关节炎的影像学检查与治疗

Imaging and Treatment of Posttraumatic Ankle and Hindfoot Osteoarthritis.

作者信息

Gorbachova Tetyana, Melenevsky Yulia V, Latt L Daniel, Weaver Jennifer S, Taljanovic Mihra S

机构信息

Einstein Medical Center, Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19141, USA.

Department of Radiology, UAB Medical Center, University of Alabama at Birmingham, Birmingham, AL 35249, USA.

出版信息

J Clin Med. 2021 Dec 13;10(24):5848. doi: 10.3390/jcm10245848.

Abstract

Posttraumatic osteoarthritis of the ankle and hindfoot is a common and frequently debilitating disorder. 70% to 90% of ankle osteoarthritis is related to prior trauma that encompasses a spectrum of disorders including fractures and ligamentous injuries that either disrupt the articular surface or result in instability of the joint. In addition to clinical evaluation, imaging plays a substantial role in the treatment planning of posttraumatic ankle and hindfoot osteoarthritis. Imaging evaluation must be tailored to specific clinical scenarios and includes weight bearing radiography that utilizes standard and specialty views, computed tomography which can be performed with a standard or a weight bearing technique, magnetic resonance imaging, and ultrasound evaluation. This review article aims to familiarize the reader with treatment rationale, to provide a brief review of surgical techniques and to illustrate expected imaging appearances of common operative procedures performed in the setting of posttraumatic ankle and hindfoot osteoarthritis, such as joint-preserving procedures, ankle fusion, subtalar fusion, tibiotalarcalcaneal fusion and ankle arthroplasty. Preoperative findings will be discussed along with the expected postoperative appearance of various procedures in order to improve detection of their complications on imaging and to provide optimal patient care.

摘要

创伤后踝与后足骨关节炎是一种常见且常导致功能障碍的疾病。70%至90%的踝骨关节炎与既往创伤有关,这些创伤涵盖一系列病症,包括骨折和韧带损伤,它们要么破坏关节面,要么导致关节不稳定。除临床评估外,影像学在创伤后踝与后足骨关节炎的治疗规划中起着重要作用。影像学评估必须根据具体临床情况进行调整,包括使用标准和特殊视图的负重X线摄影、可采用标准或负重技术进行的计算机断层扫描、磁共振成像以及超声评估。这篇综述文章旨在使读者熟悉治疗原理,简要回顾手术技术,并说明在创伤后踝与后足骨关节炎情况下进行的常见手术操作(如保关节手术、踝关节融合术、距下关节融合术、胫距跟融合术和踝关节置换术)的预期影像学表现。将讨论术前检查结果以及各种手术预期的术后表现,以便在影像学上更好地发现其并发症并提供最佳的患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb5e/8703616/204e9ca9b303/jcm-10-05848-g001.jpg

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