Hayes A G, Nadkarni J B
District General Hospital, Southport, England.
J Bone Joint Surg Br. 1996 May;78(3):468-70.
Surgical exposure of the ankle is usually obtained by an anterior approach, especially for replacement arthroplasty. The transfibular approach has been popular for arthrodesis. We describe a new posterior approach to the ankle and posterior subtalar joint based on an extra-articular vertical calcaneal osteotomy behind the subtalar joint. The posterior flap so formed is hinged medially and offers wide exposure of the back of the ankle and posterior subtalar joint. This hinge allows safe and stable reduction of the osteotomised calcaneum, and the plane of dissection follows an 'internervous plane' behind the fibula. We have had good results after using this incision in 12 patients with osteoarthritis or rheumatoid arthritis and there have been no difficulties with wound healing.
踝关节的手术显露通常采用前入路，特别是在进行置换关节成形术时。经腓骨入路在关节融合术中很常用。我们描述一种基于距下关节后方关节外垂直跟骨截骨术的踝关节及距下后关节新的后入路。如此形成的后皮瓣在内侧铰接，可广泛显露踝关节后方及距下后关节。该铰链允许安全稳定地复位截骨后的跟骨，并且解剖平面沿腓骨后方的“神经间平面”进行。我们在12例骨关节炎或类风湿关节炎患者中使用该切口后取得了良好效果，伤口愈合也没有困难。
