距骨体部が高度圧潰したCharcot足関節に対する脛踵間固定術

Tibiocalcaneal Fusion for Charcot Ankle after Severe Talar Body Bone Loss

　背景：治療に難渋することが多い距骨体部が高度圧潰したCharcot足関節に対して，ロッキングプレートを使用した関節固定術を報告する．

　対象と方法：距骨が高度に圧潰したCharcot関節の3例を対象とした．全例にPHILOSプレートを用いた脛踵間固定術を施行した．術後は8週間免荷とし，骨癒合までPTB装具を装着した．

　結果：経過中に皮膚トラブルもなく，全例で骨癒合した．

　まとめ：ロッキングプレートを用いた脛踵間固定術は簡便な手術法で，強固な固定力により骨癒合も良好である．

　Background：It is usually very difficult to treat extensive loss of the talar body.　Here, we describe the use of locking plates in tibiocalcaneal fusion for Charcot ankle reconstruction after extensive loss of the talar body.

　Methods：We performed tibiocalcaneal fusion using locking plates in 3 patients with Charcot ankle and extensive loss of the talar body.　After the operation, all patients maintained a non-weight-bearing status for the first 8 weeks, and then started to walk with a gradually increased load using a patellar tendon-bearing (PTB) brace.

　Results：All patients achieved successful fusions with restored plantigrade feet and no skin problem.

　Conclusions：Tibiocalcaneal fusion can be efficiently performed using locking plates, which allow for stable bone union due to their strong stability.