Medical Education Department, OhioHealth Grant Medical Center, Columbus, Ohio.
Foot Ankle Spec. 2024 Feb;17(1_suppl):57S-62S. doi: 10.1177/19386400221148538. Epub 2023 Jan 11.
Anterior ankle impingement syndrome can frequently present in athletes and post-traumatic patients who have osteophytes contributing to limited dorsiflexion and pain. Surgical treatment options include arthroscopy, open arthrotomy, arthrodesis, and total implant arthroplasty. For many, joint-sparing arthroscopy or arthrotomy yield satisfactory results if significant debridement is performed. If debridement is not aggressive, patients may not obtain the desired improvement. In cases where a larger amount of bone must be removed, or the patient does not have an anatomic appearing talar neck due to osteophytic changes, we have found that an open approach is necessary to achieve good results. To the best of our knowledge, no such technique has been previously published detailing a standard approach to open ankle arthrotomy. Our technique is coined the "Aggressive Open Anterior Ankle Cheilectomy" and involves a systematic 3-step approach. First, the tibial osteophytes are resected with an osteotome; second, the ankle gutters are addressed, and all hypertrophic bones removed; and third, an anatomic talar neck is fashioned. We herein describe our surgical technique and case examples.: 5.
前踝撞击综合征在运动员和创伤后患者中较为常见，这些患者的骨赘会导致背屈受限和疼痛。手术治疗方案包括关节镜检查、开放性关节切开术、关节融合术和全植入物关节置换术。对于许多人来说，如果进行了大量的清创术，关节保留的关节镜检查或关节切开术可以获得满意的效果。如果清创术不积极，患者可能无法获得理想的改善。在需要去除大量骨的情况下，或者由于骨赘变化导致患者的距骨颈没有解剖外观，我们发现需要采用开放性方法才能获得良好的效果。据我们所知，以前没有发表过详细介绍开放性踝关节切开术标准方法的此类技术。我们的技术被称为“激进的开放性前踝切除术”，包括系统的 3 步方法。首先，用骨刀切除胫骨骨赘；其次，处理踝关节沟槽，去除所有肥大的骨头；最后，塑造解剖学距骨颈。我们在此描述我们的手术技术和病例示例。
