足三關(guān)節(jié)融合術(shù)是指跟距、跟骰、距舟3個(gè)關(guān)節(jié)的融合手術(shù)。術(shù)后踝關(guān)節(jié)仍保持有活動(dòng)度。手術(shù)目的是穩(wěn)定足部關(guān)節(jié)，矯正畸形，并恢復(fù)其功能。由于這3個(gè)關(guān)節(jié)面位于兩個(gè)互相垂直的平面上，采用不同的楔形切除，可以矯正足的跖屈、仰趾、內(nèi)翻、外翻、內(nèi)收、外展或高弓畸形；兩個(gè)平面的聯(lián)合楔形切除，就可以對(duì)上述的各種聯(lián)合畸形作三維矯正。足的畸形種種不同，程度不一，因此，三關(guān)節(jié)的切骨程度、固定方法也各不有同。術(shù)前應(yīng)充分研究，對(duì)不同的畸形作出不同的設(shè)計(jì)；術(shù)中還應(yīng)根據(jù)發(fā)現(xiàn)的情況，隨時(shí)調(diào)整，才能收到滿意效果。

　　Overview（概述）

　　This surgical procedure is used to help relieve pain in the ankle joint and correct deformities in the hindfoot caused by injury, arthritis, or genetic defect. The procedure fuses the three main joints in the hindfoot that allow side-to-side movement - the calcaneo-cuboid, talonavicular, and subtalar joints.

　　三關(guān)節(jié)融合術(shù)用于緩解踝關(guān)節(jié)疼痛和矯正因外傷、關(guān)節(jié)炎或先天性缺陷導(dǎo)致的后足畸形。本術(shù)式將后足的三個(gè)主要關(guān)節(jié)（跟骰、距舟、距下關(guān)節(jié)，可進(jìn)行側(cè)向運(yùn)動(dòng)）融合在一起。

　　Preparation（準(zhǔn)備）

　　The patient is positioned so that all sides of the foot are clearly visible to the surgeon. Anesthetic is administered and the area is cleaned and sterilized.

　　患者安置妥善，從而外科醫(yī)生可以清楚地觀察足的每一側(cè)。麻醉后術(shù)區(qū)清潔消毒。

　　Accessing the Ankle Joint （顯露關(guān)節(jié)）

　　An incision is made on the outside of the foot, just below the ankle. A second incision is made on the inside of the ankle. The joints are examined and all remaining cartilage between the bones of these joints is removed. If the hindfoot is misaligned, its position is corrected.

　　在足外側(cè)剛好踝關(guān)節(jié)下方作一切口，然后在踝關(guān)節(jié)內(nèi)側(cè)作第二個(gè)切口。檢查關(guān)節(jié)，將這些關(guān)節(jié)骨間的殘余軟骨去除。如果后足排列異常，矯正其位置。

　　Fusing the Joint（融合關(guān)節(jié)）

　　Screws, staples, or plates are inserted to stabilize the bones of the joint. Bone graft is packed around the space between the bones if needed. Over time, these bones will fuse together.

　　用螺釘、矩形釘或鋼板將關(guān)節(jié)的骨頭固定。如有必要，在骨頭之間的空隙內(nèi)植入骨移植物。經(jīng)過一段時(shí)間，這些骨頭會(huì)融合到一起。

　　End of Procedure and After Care（手術(shù)結(jié)束和術(shù)后護(hù)理）

　　The incision is closed with sutures or surgical staples. The ankle may be placed in a brace or half-cast, and a short hospital stay will be required. Weight should not be applied to the foot for at least six weeks after the surgery. A walking cast may then be used for at least another six weeks. Full recovery usually takes up to ten months.

　　縫合或用皮釘關(guān)閉切口。用支具或石膏托固定踝關(guān)節(jié)。需要短期住院。術(shù)后患足不能負(fù)重至少6周。此后使用行走石膏至少6周。完全康復(fù)通常需要10個(gè)月。

　　(胡佰文    譯）