踝关节镜技术.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,关节镜技术在治疗踝关节疾病中的应用,济南军区总医院 骨病科,1,1981,年,Johnson,第,1,个在美国文献上发表踝关节镜的手术报告。,1988,年徐锦森在国内首先报道踝关节镜的应用。,随着关节镜技术的进步和手术器械的完善,踝关节镜手术的适应证逐步拓宽。,2,解剖及入路,3,4,5,术中体位,6,7,8,9,10,11,12,21 Point examination(Ferkel),8 anterior(anteromedial portal),6 central(anteromedial portal),7 posterior(posterolateral portal),常规检查顺序及内容,13,14,15,16,手术适应症,踝关节撞击征,17,踝关节撞击征,刘建强 男,30,岁,18,软骨退变 游离体形成,R,19,关节清理术后,20,清除的骨赘及游离体,21,剥脱性骨软骨炎,王会余 男,65,岁,22,软骨剥脱,23,外踝骨折,王岩 男,24,岁,24,软组织撞击,25,26,27,术后复查,28,关节镜辅助下踝关节融合术,孔德春 男性,52,岁,29,30,31,32,术后,33,植入异体骨条,34,关节清理后不植骨,35,并发症,RD Ferkel,(Arthroscopy 1996),612 patients 27,例出现并发症,(4.4%),15,腓浅神经,6,腓肠神经,5,大隐静脉,1,腓深神经,36,并发症,www.arthroscopyjournal.org/scripts/om.dll/serve?action=image&location=/extractor/images/ar/16/1/h0160021002.jpg&link=/extractor/images/ar/16/1/f0160021002.jpg&hires=on,(Arthroscopy April 2001),假性动脉瘤,pseudoaneurysm,37,小结,踝关节镜手术创伤小，痛苦小，恢复快，副作用少，疗效确切。,对关节镜技术要求高,38,Thank You,39,