骨科手术早知道00４：踝关节置换术（ANKLE REPLACEMENT）
《人工踝关节外科学》第二版封面
《人工踝关节外科学》第一版 前言（部分）
《人工踝关节外科学》第二版 前言（部分）
《人工踝关节外科学》第二版 编著者和单位
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Overview（概述）
During this procedure, the surgeon removes diseased or damaged portions of the ankle. The surgeon implants an artificial ankle joint consisting of metal and plastic components. The new joint will help reduce pain and restore mobility to the ankle.
在踝关节置换术中，外科医生将踝关节病变或受破坏的部分去除，然后植入由金属和塑料部件组成的人工踝关节。新的关节有助于减轻疼痛并保留踝关节的活动。
Preparation（准备）
In preparation for the procedure, anesthesia is administered and the ankle is cleansed with an antiseptic solution.
准备手术时，对患者实施麻醉，术区清洁消毒。
Removing Damaged Bone（去除受破坏的骨）
The surgeon creates an incision in the front of the ankle. The joint is carefully examined. The surgeon prepares the joint for the new components by removing a portion of the tibia and the talus. The surgeon may also remove a portion of the fibula.
外科医生在踝关节前方作一切口，仔细检查关节，通过去除胫骨和距骨一部分为新的关节组件植入作好准备，可能还会去除一部分腓骨。
Inserting the Implant（植入假体）
After the joint is prepared, the surgeon inserts the components of the artificial ankle. The talar component replaces the top of the talus, and the tibial component is fitted into the end of the tibia. A plastic cup positioned between these two components will allow them to glide smoothly against each other.
当关节作好准备后，外科医生植入人工踝关节组件。距骨组件代替距骨的顶部，胫骨组件与胫骨的远端相匹配。在两个组件之间，植入一个塑料杯，使它们相互之间可以流畅地滑动。
Stabilizing the Implant（稳定假体）
Depending on the patient's need, the surgeon may also choose to fuse the fibula and tibia. The surgeon may place bone graft between these bones to encourage them to grow together, or the surgeon may use a plate and screws.
根据病情的需要，外科医生可能还会选择融合腓骨和胫骨。外科医生可能在这些骨之间植入骨移植物以促进它们长到一起，或者，外科医生会使用接骨板或螺钉。
End of Procedure（手术结束）
When the implantation is complete, the surgeon tests the new ankle joint to make sure the components fit together properly. The incision is closed with sutures or surgical staples. The ankle is bandaged and placed in a splint or a cast.
当植入完成后，外科医生测试新的踝关节，以确保假体之间相互匹配合适。缝合或用皮钉关闭切口。踝关节用绷带包扎，并用夹板或石膏固定。
Aftercare（术后护理）
After healing, the patient will begin physical therapy. The patient will not be allowed to place weight on the ankle for at least six weeks. An ankle support may be required for up to one year after the surgery.
在愈合后，患者将开始物理治疗。踝关节避免负重至少6周。术后可能需要踝关节支架保护长达1年时间。
（胡佰文 译）
毛宾尧教授专家门诊时间
周一上午 周二下午