Lameire Darius Luke, Abdel Khalik Hassaan, Del Balso Christopher, Daniels Timothy, Halai Mansur
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Foot Ankle Orthop. 2023 Feb 28;8(1):24730114231156422. doi: 10.1177/24730114231156422. eCollection 2023 Jan.
There is currently a scarcity of information and consensus for transportal (arthroscopic or fluoroscopic) joint preparation during tibiotalocalcaneal (TTC) fusion, and therefore this review aims to summarize the available techniques and to evaluate the outcomes after this procedure.
A systematic electronic search of MEDLINE, EMBASE, and Web of Science was performed for all English-language studies published from their inception to April 4, 2022. All articles addressing arthroscopy in TTC nailing were eligible for inclusion. The PRISMA Checklist guided the reporting and data abstraction. Descriptive statistics are presented.
A total of 5 studies with 65 patients were included for analysis. All studies used arthroscopic portals for tibiotalar and subtalar joint preparation (in 4 studies) prior to TTC nailing, with 4 studies using an arthroscope and 1 study using fluoroscopy. The overall major complication rate was 13.8%; however, there was only 1 instance of deep wound infection (1.5%) and 4 instances of surgical site infections (6.2%). Full fusion was achieved in 86% of patients with an average time to fusion of 12.9 weeks. The mean American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score preoperatively was 34.0 and postoperatively was 70.5.
Although limited by the number of studies, transportal joint preparation during TTC nail ankle fusion is associated with good rates of complications and successful fusion.
Level III, systematic review of Level III-IV studies.
目前，在胫距跟（TTC）融合术中，关于经皮（关节镜或透视）关节准备的信息匮乏且缺乏共识，因此本综述旨在总结现有技术并评估该手术后的结果。
对MEDLINE、EMBASE和科学网进行系统的电子检索，以查找从创刊至2022年4月4日发表的所有英文研究。所有涉及TTC钉固定术中关节镜检查的文章均符合纳入标准。PRISMA清单指导报告和数据提取。呈现描述性统计数据。
共纳入5项研究，65例患者进行分析。所有研究在TTC钉固定术前均使用关节镜入路进行胫距关节和距下关节准备（4项研究），其中4项研究使用关节镜，1项研究使用透视。总体主要并发症发生率为13.8%；然而，仅1例深部伤口感染（1.5%）和4例手术部位感染（6.2%）。86%的患者实现了完全融合，平均融合时间为12.9周。术前美国矫形足踝协会（AOFAS）踝后足评分平均为34.0，术后为70.5。
尽管受研究数量限制，但TTC钉踝关节融合术中经皮关节准备的并发症发生率和融合成功率良好。
III级，III-IV级研究的系统评价。
