Fellmann J, Zollinger H
Orthopädischen Universitätsklinik Balgrist Zürich.
Z Orthop Ihre Grenzgeb. 1996 Jul-Aug;134(4):341-5. doi: 10.1055/s-2008-1039772.
Triple arthrodesis respects the functional unit of the subtalar joint, but shows several intraoperative difficulties such as surfaces of resection that are too large or wrong positions between the hind and the middle foot. Furthermore postoperative problems like walking on uneven pavements, a reduced range of motion in the adjacent joints and the development of osteoarthritis of the ankle are not easy to deal with. Therefore isolated fusions of the talocalcaneal, talonavicular and calcaneo-cuboidal joint with a minimal resection technique seem to present several advantages. Among them we would mention a minimal reduction of the range of motion, the preservation of a physiological position of the adjacent joints and the prevention of osteoarthritis in the adjacent joint which rarely appears and when it does only in an asymptomatic form. The subtalar implants and the astragaloplasty as possibilities to treat disorders of the subtalar joint complex are also discussed.
三关节融合术保留了距下关节的功能单元，但存在一些术中困难，比如切除面过大或后足与中足之间位置错误。此外，术后问题，如在不平整路面行走、相邻关节活动范围减小以及踝关节骨关节炎的发展，都不易处理。因此，采用最小切除技术对距跟、距舟和跟骰关节进行单独融合似乎具有几个优点。其中我们会提到活动范围最小程度的减小、相邻关节生理位置的保留以及相邻关节骨关节炎的预防，这种情况很少出现，即便出现也只是无症状形式。还讨论了距下关节植入物和距骨成形术作为治疗距下关节复合体疾病的可能性。
