Transankle lateral tuberculosis debridement and arthrodesis

Surgical treatment of ankle joint tuberculosis by lateral ankle joint tuberculosis and arthrodesis. The ankle joint is the one that bears the most weight of the body. Therefore, the ankle anatomy requires firmness and stability. There are many ligaments around the ankle joint, which keeps the ankle joint stable. When the ankle joint is destroyed by tuberculosis, pathological dislocation is rare. In addition, the ankle joint is limited to one plane of flexion and extension, and the range of motion is small. It is only important when the squat and the upslope are active. It has little effect on the general walking, and the ankle joint needs to be stable and painless. Therefore, In the treatment of ankle joint tuberculosis, joint fusion is one of the often used treatments. Simple synovial tuberculosis is not effective after non-surgical treatment, or the synovial membrane has been significantly thickened should be synovial resection, local obvious bone or lesions may invade the joint may be simple bone tuberculosis, should be promptly used lesion clearance therapy. Early total joint tuberculosis with pathological activity, such as no surgical contraindications, should also be treated with lesion removal therapy to achieve the purpose of stopping the development of the lesion in time and rescuing the joint function. For cases of advanced joint tuberculosis or recurrence of lesions, because there is no problem of salvage joint function, non-surgical therapy can be used for treatment, non-surgical therapy is ineffective, or lesion removal therapy can be used for shortening the course of treatment. Treatment of diseases: ankle joint tuberculosis Incision From the outer iliac crest 10 cm, along the outer edge of the humerus down to the outer malleolus tip slightly curved to the back of the foot 2cm. 2. revealing the lesion The skin and subcutaneous tissue were dissected, the periosteum of the tibia was dissected, and the periosteum was dissected. The tibia was sawn with a wire saw 10 cm above the lateral malleolus, and the interosseous membrane, joint capsule and ligament attached to the tibia were removed, and the tibia was removed. The foot is turned inward, the talus is dislocated, and the lesion is completely revealed. The joint capsule and synovium were removed and the diseased tissue in the joint was scraped off. 3. Joint fusion The articular cartilage above the talus and below the tibia (including the medial malleolus) was removed with a bone knife. Put the ankle joint together. Note that the joints of the medial malleolar ligament must be cut off to make the joints tight. The ankle joint was placed at a position of 90° to 100°. Two screws were placed on the humerus to fix the talus, and one screw was placed on the lower end to fix the humerus. Note that the screw should pass through the contralateral cortical bone. If the ankle joint space is too large after placement of the humerus, a bone groove can be drilled into the lateral cortical bone of the humerus, and the tibia can be inserted into the bone groove so that the ankle joint can be closely aligned. 4. Close the wound Rinse the wound and place 1 g of streptomycin into the joint. The wound is sutured in layers. The knee plaster is fixed.