Lortat-Jacob A, Beaufils P, Coignard S, Elahmadi J
Rev Chir Orthop Reparatrice Appar Mot. 1984;70(6):449-56.
The authors have performed 28 ankle fusions for septic causes. There were 23 cases of septic arthritis and 5 severely comminuted compound fractures treated by primary fusion. Arthrodesis was made after wide excision and stabilization by external fixator. In 23 cases secondary bone grafting was done. Only in 13 cases was a satisfactory contact between the bony surfaces obtained. There was no contact at all in 9 cases. The authors have had good experience with the A.L.J. model of external fixator. On 7 occasions, secondary grafting was made using a cortico-cancellous graft with 3 failures. On 6 occasions, the Papineau technique was used with success but healing was slow. Out of 24 patients, the final result was good in 18 with 4 failures of fusion and 3 persistent sinuses. The importance of a wide excision is emphasised leading to the need for the use of external fixation. In cases of skin loss in recent comminuted fractures, the Papineau method is indicated as a primary procedure.
作者已对28例因感染导致的踝关节融合术进行了研究。其中有23例化脓性关节炎和5例严重粉碎性复合骨折采用一期融合治疗。在广泛切除并通过外固定器稳定后进行关节融合术。23例患者进行了二期植骨。仅13例患者实现了骨面之间的满意接触。9例患者骨面完全没有接触。作者在使用A.L.J.型号外固定器方面有良好经验。7次使用皮质松质骨移植进行二期植骨，其中3次失败。6次使用帕皮诺技术获得成功，但愈合缓慢。24例患者中，18例最终结果良好，4例融合失败，3例存在持续窦道。强调了广泛切除的重要性，这导致需要使用外固定。在近期粉碎性骨折伴有皮肤缺损的病例中，帕皮诺方法可作为首选术式。
