距下关节镜(英文)

Subtalar arthroscopy

距下关节是复杂的后足结构,可作内翻及外翻运动,具有重要的生物力学作用。距下关节由两个独立的关节腔共同组成,包括距跟舟关节(前距下关节)及距跟关节(后距下关节),两个关节腔被跗骨窦及跗骨管所分隔。后距下关节镜的经典入路包括外侧入路或后侧入路,然而,这两种经典入路下仍无法完全暴露后距下关节的内侧部分及跗骨管。为此,后距下关节镜的内侧入路及跗骨管入路应运而生,补充了经典入路的不足,使关节镜下完全暴露后距下关节成为可能。同样,前距下关节镜配合内侧距下关节和距舟关节镜可完全暴露前距下关节。随着手术器械及操作技术的进步,距下关节的不同部位的病变均能镜下观察及操作。

Subtalar joint is a complex but biomechanically important joint in rear foot in controlling inversion and eversion of the foot. It has two articulations, talocalcaneonavicular joint （ anterior subtalar joint） and talocalcaneal joint （ posterior subtalar joint）. They are separated by the sinus tarsi and the tarsal canal. There is no connection between the two articulations normally. Posterior subtalar arthroscopy is classically performed by lateral or posterior approach. However the medial part of the posterior subtalar joint and the tarsal canal cannot be reached by the classic approach. The development of medial subtalar arthroscopy and the tarsal canal arthroscopy complement the standard lateral and posterior approaches and make complete access of the posterior subtalar joint possible. Similarly, complete access to the anterior subtalar joint is possible with the anterior subtalar arthroscopy, medial subtalar arthroscopy and talonaricular arthroscopy. With the advent in surgical techniques and instrumentations, various parts of subtalar joint can now be reached arthroscopically and different subtalar pathologies can be dealt with arthroscopically.