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[踝关节骨关节炎的截骨术转换(内踝上和内踝下)-预期效果如何?:文献综述]

[Conversion osteotomy for arthrosis of the ankle joint (supramalleolar and inframalleolar)-What can be expected? : Critical review of the literature].

作者信息

Stukenborg-Colsman Christina, Ettinger Sarah, Claassen Leif, Daiwei Yao, Plaass Christian

机构信息

Department Fuß- und Sprunggelenkchirurgie, Orthopädische Klinik, DIAKOVERE Annastift, Medizinische Hochschule Hannover, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.

出版信息

Unfallchirurg. 2022 Mar;125(3):189-195. doi: 10.1007/s00113-022-01142-7. Epub 2022 Feb 11.

Abstract

The aim of supramalleolar conversion osteotomy is to reduce the pain of the patient and stop or at least slow down joint degeneration. The indication for supramalleolar osteotomy is asymmetric osteoarthritis of the ankle joint with varus or valgus deformity. Good clinical results for arthritis can be achieved in the early or middle stages. Besides closing and opening wedge osteotomies dome osteotomy is sometimes indicated, especially for larger deformities. The preoperative preparation of individual patient-specific section blocks facilitates the intraoperative implementation and seems to increase the precision. Further studies are necessary to support this. The indications for additional procedures, such as fibular osteotomy are still being discussed. Inframalleolar osteotomy and soft tissue interventions are frequently necessary for balancing the foot.

摘要

踝关节上截骨术的目的是减轻患者疼痛,阻止或至少减缓关节退变。踝关节上截骨术的适应证为伴有内翻或外翻畸形的踝关节不对称性骨关节炎。在早期或中期可取得良好的关节炎临床疗效。除了闭合和开放楔形截骨术外,有时还需行穹顶截骨术,尤其是对于较大畸形。术前准备个体化的患者特异性截骨块有助于术中操作,且似乎能提高精确度。需要进一步研究予以支持。诸如腓骨截骨术等附加手术的适应证仍在讨论中。为平衡足部,常常需要进行踝关节下截骨术和软组织干预。

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