Negru Teodor, Lopes Ronny
Foisor Orthopedics Hospital Bucharest, Bucharest, Romania.
Clinique Brétéché, Nantes cedex 1, France.
Arthrosc Tech. 2022 Jul 14;11(8):e1403-e1407. doi: 10.1016/j.eats.2022.03.029. eCollection 2022 Aug.
Resection of symptomatic talocalcaneal coalitions (TCCs) has been performed for patients with normal tarsal joints and <50% involvement of the subtalar joint. For those with TCCs >50% of subtalar articulation or/and subtalar arthritis, a subtalar arthrodesis is done. The purpose of this Technical Note is to describe the arthroscopic resection of TCC and talocalcaneal arthrodesis during the same procedure by using a 2 lateral portal technique With the patient in lateral decubitus under general or locoregional anaesthesia, the foot and ankle are extended beyond the edge of the surgical table. A lateral portal is created 1 cm anterior to the tip of the lateral malleolus in which the arthroscope is introduced. The anterolateral portal is created 1 cm inferior and 2 cm anterior to the tip of the lateral malleolus. The posterior subtalar surface is prepared progressively. The TCC resection is completed. The fixation is obtained with 2 cannulated screws. The arthroscopic resection of TCC and subtalar arthrodesis during the same procedure by using 2 lateral portals can be done for correctly selected patients.
对于跗关节正常且距下关节受累小于50%的有症状距跟联合（TCC）患者，可行切除术。对于距下关节受累超过50%或/和存在距下关节炎的TCC患者，则行距下关节融合术。本技术说明的目的是描述通过双外侧入路技术在同一手术过程中进行关节镜下TCC切除术和距跟关节融合术。患者在全身或局部麻醉下侧卧，足和踝关节伸展超过手术台边缘。在外侧踝尖前方1 cm处建立外侧入路，插入关节镜。在前外侧入路在外侧踝尖下方1 cm、前方2 cm处建立。逐步处理距下关节后表面。完成TCC切除术。用2枚空心螺钉进行固定。对于经过正确选择的患者，可以通过双外侧入路在同一手术过程中进行关节镜下TCC切除术和距下关节融合术。
