医学动画：全踝关节置换术（Total Ankle Replacement）

　　当踝关节严重退变或损伤，以及其它病变造成关节软骨严重损伤，产生顽固性疼痛和关节僵硬，如病人不愿意接受踝关节融合术，可考虑行踝关节置换术。术后踝关节疼痛减轻，活动范围改善。

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Total Ankle Replacement

全踝关节置换术

If a person has severe arthritis of the ankle, a doctor may recommend a surgical procedure called ankle arthroplasty, or total ankle replacement.

　　如果踝关节得了严重的关节炎，医生可能会推荐进行踝关节成形术（踝关节置换术）。

The ankle is the joint that connects the leg and the foot. The ankle joint includes the two lower leg bones, called the tibia and the fibula, and the ankle bone called the talus. 

　　踝关节是连接腿与足的关节，包括两块小腿的骨头（胫骨和腓骨）和踝骨（距骨）。

The ankle joint allows the foot to move up and down. On the ends of the bones is a smooth gliding covering called articular cartilaget.

　　踝关节使足可以上下活动。骨端覆盖着一层光滑的关节软骨。

Sometimes, the ankle can become damaged from injury or normal wear and tear, or other diseases. These can result in arthritis, which is painful joint inflammation and stiffness.

　　有时，因为损伤或正常的磨损或撕裂以及其它疾病，踝关节会受到破坏， 引起关节炎，导致关节疼痛和僵硬。

Overtime, the articular cartilage can wear away, causing the exposed bony surfaces to  rub together. 

　　久之，关节软骨会磨损，导致骨表面外露，相互磨擦。

In addition, arthritis can lead to changes in the shape of the bones of the ankle joint, for example, bony projections  called bone spurs, can develop. The bone spurs, along with the damaged cartilage, can make it hard to move the foot up and down. As a result, it can difficult to walk, and go up and down stairs. 

　　另外，关节炎会导致踝关节的骨头的外形发生改变，比如，会产生骨性突起（骨刺）。骨刺和软骨损伤一起，使足上下活动困难。结果，行走或上下楼梯就会变得困难。

Two types of arthritis that can affect the ankle joint are: osteoarthritis due to wear and tear on the joint or injury, and rheumatoid arthritis, one of several auto-immune disorders that causes inflammation of joint.

　　两类影响踝关节的关节炎包括：因关节磨损撕裂或损伤引起的骨关节炎和类风湿性关节炎， 后者是可引起关节炎症的许多自身免疫性疾病之一。

A surgical procedure called total ankle replacement is done to replace a severely damaged  ankle joint.

　　全踝关节置换术用于更换严重损坏的踝关节。

The surgeon will make an incision on the front of the damaged ankle to review the ankle joint. Next, the ends of the tibia and talus will be removed. A man made joint called an implant or prosthesis will be inserted into the ankle. At the end of the procedure, the incision will be closed with stitches. 

　　术者首先在受损踝关节的前方作一切口，以检查踝关节。 然后，去除胫骨和距骨的骨端，接着，在踝关节内插入人造的关节，称为植入物或假体。最后，用缝线缝合关闭切口。

After ankle replacement, the patient will be able to move the ankle more fully, and experience less pain during activity.

　　在踝关节置换术后，病人的踝关节可以更灵活地活动，在活动时疼痛也更加轻微。

（胡佰文  听译）

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