距骨骨折脱位手术入路的解剖研究与临床应用

Surgical Approach for Operative Treatment of Frac-ture and Dislocation of the Talus

作者为避免在距骨骨折合并脱位手术时发生因手术本身所导致的距骨供血动脉损伤的可能性，降低术后距骨缺血性坏死的发生率。通过距骨血供系统与手术入路关系的应用解剖研究，提出腓骨下端截骨向后外翻转，充分显露踝关节的最佳手术入路，克服原常用踝关节前外侧等切口入路以及应用杠杆撬拨复位手术方法的缺点，临床应用１４例，径１～２年时间的随访，Ｘ线检查尚未发现１例距骨缺血性坏死，取得效果良好。

Abstract In order to avoid injury of the arterial supply of themlus anddecrease the incidence of postoperative avascular necrosis,the authors,based on the anatomical study of the blood supply of the talus,had designed new approach for the talus through ostecotomy of the lower and of the tibu-la. Complete exposure of the ankle joint can be accom-plished by lateral tilting of the cateotomized lower end ofthe fibula. The shortcom i ngs of the an te r ior approach ofthe ank le joint and the red uction by le verage action canthus be avoided. Clinical use of this approach in 14 caseswith a follow-up poried of 1～2 years revealed satisfacto-ry results in all. No postoperative avascular necrosis of thetalus was seen on radiographies.