中华关节外科杂志(电子版)
中華關節外科雜誌(電子版)
중화관절외과잡지(전자판)
CHINESE JOURNAL OF JOINT SURGERY(ELECTRONIC VERSION)
2014年
4期
519-523
,共5页
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。
<br> 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。
距下關節是複雜的後足結構,可作內翻及外翻運動,具有重要的生物力學作用。距下關節由兩箇獨立的關節腔共同組成,包括距跟舟關節(前距下關節)及距跟關節(後距下關節),兩箇關節腔被跗骨竇及跗骨管所分隔。
<br> 後距下關節鏡的經典入路包括外側入路或後側入路,然而,這兩種經典入路下仍無法完全暴露後距下關節的內側部分及跗骨管。為此,後距下關節鏡的內側入路及跗骨管入路應運而生,補充瞭經典入路的不足,使關節鏡下完全暴露後距下關節成為可能。同樣,前距下關節鏡配閤內側距下關節和距舟關節鏡可完全暴露前距下關節。隨著手術器械及操作技術的進步,距下關節的不同部位的病變均能鏡下觀察及操作。
거하관절시복잡적후족결구,가작내번급외번운동,구유중요적생물역학작용。거하관절유량개독립적관절강공동조성,포괄거근주관절(전거하관절)급거근관절(후거하관절),량개관절강피부골두급부골관소분격。
<br> 후거하관절경적경전입로포괄외측입로혹후측입로,연이,저량충경전입로하잉무법완전폭로후거하관절적내측부분급부골관。위차,후거하관절경적내측입로급부골관입로응운이생,보충료경전입로적불족,사관절경하완전폭로후거하관절성위가능。동양,전거하관절경배합내측거하관절화거주관절경가완전폭로전거하관절。수착수술기계급조작기술적진보,거하관절적불동부위적병변균능경하관찰급조작。
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 .
<br> 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 .