■关节固定术被认为是治疗保守治疗失败的终末期踝关节关节炎的金标准。实现工会是最重要的,同时尽量减少并发症。成功结合的一个重要项目是准备关节面。我们的研究旨在评估直接侧向和双微型开放方法之间联合准备的差异。
■本研究使用十个膝下新鲜冷冻的样本。五个是通过横向进近准备的,和五个使用双迷你切口。准备之后,解剖所有脚踝,并拍摄胫骨平台和距骨关节面的图像。关节面和距骨未加工软骨的表面区域,胫骨远端,并对腓骨远端进行了测量和分析。
■与经腓骨入路相比,微开放入路制备了更大量的总表面积。总关节表面(包括距骨和胫骨/腓骨)的准备表面积百分比,距骨,胫骨,经腓骨入路腓骨占76.9%,77.7%,75%,分别。百分比为90.9%,92.9%,和88.6%的微型开放方法。当不包括内侧排水沟时,技术之间没有显著差异(83.94%vs.90.85%,p=0.1412)。
■微型开放入路的关节准备与胫骨关节的经腓骨入路同样有效。微型开放方法确实为内侧沟和胫骨下表面提供了出色的准备,这可能有助于提高愈合率并减少并发症。
■V.
BACKGROUND: Arthrodesis is considered the gold standard for end-stage ankle arthritis in patients who fail conservative management. Achieving union is paramount while minimizing complications. An essential item for successful union is preparation of the articular surface. Our study aims to evaluate the difference in joint preparation between direct lateral and dual mini-open approaches.
METHODS: Ten below knee fresh-frozen specimens were used for this study. Five were prepared through lateral approach, and five using dual mini-incisions. After preparation, all ankles were dissected and images of tibial plafond and talar articular surfaces were taken. Surface areas of articulating facets and unprepared cartilage of talus, distal tibia, and distal fibula were measured and analyzed.
RESULTS: A greater amount of total surface area was prepared with the mini-open approach in comparison to the transfibular approach. Percentage of prepared surface area of total articulating surface (including talus and tibia/fibula), talus, tibia, and fibula with the transfibular approach were 76.9%, 77.7%, and 75%, respectively. Percentages were 90.9%, 92.9%, and 88.6% with the mini-open approach. When excluding medial gutter, there was no significant difference between techniques (83.94% vs. 90.85%, p = 0.1412).
CONCLUSIONS: Joint preparation with the mini-open approach is equally efficacious as the transfibular approach for the tibiotalar joint. The mini-open approach does provide superior preparation of the medial gutter and inferior tibial surface which may help to increase union rates and decreased complications.
METHODS: V.