Zhang Tao, Li Zhenhao, Cui Yan, Xiong Wanqi, Wang Zewen, He Ting, Liu Jiahe, Xu Jingyi, Liu Baoyi, Yang Fan
Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Apr 15;38(4):493-497. doi: 10.7507/1002-1892.202401007.
To summarize the surgical treatment methods for avascular necrosis of the talus.
The recent domestic and international literature related to avascular necrosis of the talus was extensively conducted. The pathogenesis, surgical treatment methods, and prognosis were summarized.
The clinical symptoms of avascular necrosis of the talus at early stage are not obvious, and most patients have progressed to Ficat-Arlet stages Ⅲ-Ⅳ and require surgical treatment. Currently, surgical treatments for this disease include core decompression, vascularized bone flap transplantation, arthroplasty, and arthrodesis, . Early avascular necrosis of the talus can be treated conservatively, and if treatment fails, core decompression can be considered. Arthrodesis is a remedial surgery for patients with end-stage arthritis and collapse, and in cases of severe bone loss, tibiotalocalcaneal arthrodesis and bone grafting are required. Vascularized bone flap transplantation is effective and plays a role in all stages of avascular necrosis of the talus, but the appropriate donor area for the flap still needs further to be studied.
The surgical treatment and the system of treatment for different stages of avascular necrosis of the talus still need to be refined.
总结距骨缺血性坏死的外科治疗方法。
广泛查阅近期国内外有关距骨缺血性坏死的文献，总结其发病机制、外科治疗方法及预后。
距骨缺血性坏死早期临床症状不明显，多数患者已进展至Ficat-ArletⅢ-Ⅳ期，需手术治疗。目前，该病的手术治疗方法包括髓芯减压、带血管蒂骨瓣移植、关节成形术和关节融合术。距骨早期缺血性坏死可保守治疗，若治疗失败，可考虑髓芯减压。关节融合术是终末期关节炎和塌陷患者的补救性手术，严重骨缺损时，需行胫距跟关节融合术并植骨。带血管蒂骨瓣移植有效，在距骨缺血性坏死各阶段均起作用，但皮瓣合适的供区仍需进一步研究。
距骨缺血性坏死不同阶段的外科治疗及治疗体系仍需完善。
