| Autor: |
Gross CE; Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina., Sershon RA; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Frank JM; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Easley ME; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina., Holmes GB Jr; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois. |
| Jazyk: |
angličtina |
| Zdroj: |
JBJS reviews [JBJS Rev] 2016 Jul 12; Vol. 4 (7). |
| DOI: |
10.2106/JBJS.RVW.15.00087 |
| Abstrakt: |
More than 60% of the talar surface area consists of articular cartilage, thereby limiting the possible locations for vascular infiltration and leaving the talus vulnerable to osteonecrosis. Treatment strategies for talar osteonecrosis can be grouped into four categories: nonsurgical, surgical-joint sparing, surgical-salvage, and joint-sacrificing treatments. Nonoperative and joint-sparing treatments include restricted weight-bearing, patellar tendon-bearing braces, bone-grafting, extracorporeal shock wave therapy, internal implantation of a bone stimulator, core decompression, and vascularized or non-vascularized autograft, whereas joint-sacrificing or salvage procedures include talar replacement (partial or total) and arthrodesis. In patients with a Ficat and Arlet grade-I through III osteonecrosis, evidence in favor of a specific treatment is poor, although tibiotalar or tibiotalocalcaneal arthrodesis may represent a suitable salvage operation. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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