University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl-Gustav Carus at TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany.
University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl-Gustav Carus at TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany.
Foot Ankle Clin. 2022 Dec;27(4):745-767. doi: 10.1016/j.fcl.2022.07.002.
Chronic injuries at the tarsometatarsal joint represent a wide array of painful malunions ranging from isolated instability to complex three-dimensional deformities with rapid development of posttraumatic arthritis. Deformity correction and arthrodesis of the symptomatic joints leads to significant pain reduction and functional improvement provided that realignment of the anatomic axes is achieved. Arthrodesis should be limited to the first to third tarsometatarsal joints, whereas interposition arthroplasty is preferred for symptomatic arthritis of the fourth to fifth tarsometatarsal joints. For complex deformities and instability, the intercuneiform and naviculocuneiform joints may need to be included into corrective fusion.
跗跖关节的慢性损伤表现为一系列疼痛性畸形愈合，范围广泛，从单纯的不稳定到复杂的三维畸形，迅速发展为创伤后关节炎。对于有症状的关节，通过矫正畸形和融合，可以显著减轻疼痛并改善功能，前提是实现解剖轴的对线。融合应限于第一至第三跗跖关节，而对于第四至第五跗跖关节的有症状关节炎，应首选间置关节成形术。对于复杂的畸形和不稳定，可能需要将楔骨间和楔骨舟状骨关节包括在内进行矫正融合。
