tailieunhanh - Total Ankle Arthroplasty - part 2

Sau chấn thương nặng vẹo viêm xương khớp. Sáu mươi mốt tuổi, nam bệnh nhân viêm xương khớp sau chấn thương (a, b ) Sau khi Bong gân mắt cá chân nhiều, tenodesis, và gãy xương mác, và sự bất ổn của Than phiền Khi trọng lượng mang bánh mì trên bàn chân: trật khớp anterolateral và malalignment vẹo của mái trong các lỗ mộng mắt cá chân | Characteristics of Ankle Arthritis 7 a b d c e f g h Fig. . Severe post-traumatic varus osteoarthrosis. Sixty-one-year-old male patient with post-traumatic osteoarthrosis a b after multiple ankle sprains tenodesis and fibula fracture complaining of instability and pain when weight-bearing on the foot anterolateral dislocation and varus malalignment of the talus in the ankle mortise c-e breakdown of the anteromedial tibial plafond cavus deformity f dynamic pedobarography Emed-System Novel Munich Germany dorsi- plantar flexion 5 - 0 - 30 g h 8 Chapter 2 Characteristics of the Diseased Ankle stand the basic problem namely the pathology and varieties of ankle arthritis. Ankle arthritis includes primary and secondary arthritis post-traumatic osteoarthritis and systemic arthritis neuropathic arthropathy inflammatory arthritis and rarely infectious arthritis . Osteoarthrosis is probably a better descriptive term for primary and post-traumatic arthritis conditions as it minimizes the inflammatory component of this disorder. Primary Osteoarthrosis Primary osteoarthrosis is characterized by loss of joint cartilage and hypertrophy of bone. The exact mechanisms have not been defined but subchondral bone injury and mechanical stress contribute to the damage 9 . The radiographic hallmarks are jointspace narrowing which correlates with loss of joint cartilage osteophyte formation subchondral bone cysts and subchondral sclerosis. 5 There is usually an absence of juxta-articular osteoporosis in primary osteoarthrosis Fig. . Post-Traumatic Osteoarthrosis While hip and knee osteoarthrosis is predominantly of degenerative etiology and seen in older patients 80 of ankle arthritis is post-traumatic in origin 3 and occurs therefore mostly in younger patients. Post-traumatic osteoarthrosis usually occurs secondary to an intra-articular fracture of the weight-bearing ankle joint Fig. 4 8 10 . a b c d Fig. . Bilateral rheumatoid arthritis of the ankle. .