关节镜手术治疗踝关节后方撞击综合征

发布时间：2018-07-04 10:50

本文选题：后踝 + 撞击综合征　；参考：《中国微创外科杂志》2017年06期

【摘要】：目的探讨关节镜手术治疗踝关节后方撞击综合征的疗效。方法 2008年1月~2015年11月因踝关节后方撞击综合征接受关节镜手术30例,男18例,女12例。年龄19~58岁,平均37.6岁。右踝19例,左踝11例。27例有明确踝关节外伤史,其中急性损伤7例,慢性损伤20例。采用后内、外侧入路行关节镜下骨赘去除,软骨成形,关节清理等治疗。采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)后足-踝评分及疼痛视觉模拟评分(Visual Analogue Scale,VAS)评估踝关节功能。结果所有患者术后均获得随访,随访时间8~27个月,平均22个月。无血管、神经损伤。末次随访时,AOFAS评分从术前的(35.0±10.1)分提高至(89.8±3.8)分(t=-26.456,P=0.000);VAS评分从术前的(6.6±1.9)分下降为(2.5±1.3)分(t=12.427,P=0.000),踝关节跖屈角度从术前的29.4°±2.3°提高至43.4°±1.4°(t=-32.625,P=0.000)。优21例,良9例,优良率100%。结论关节镜下行踝关节清理及并发症的处理是治疗踝关节后方撞击征的有效方法之一,具有微创、安全、针对性强、术后功能恢复快等优点。
[Abstract]:Objective to evaluate the effect of arthroscopic treatment of posterior ankle impingement syndrome. Methods from January 2008 to November 2015, 30 patients (18 males and 12 females) underwent arthroscopic surgery due to posterior impact syndrome of ankle joint. The average age was 37.6 years. There were 19 cases of right malleolus and 11 cases of left malleolus, including 7 cases of acute injury and 20 cases of chronic injury. Arthroscopic osteophyte removal, cartilage formation and joint cleaning were performed via posterior and lateral approach. The ankle function was evaluated by American Orthopedic foot and Ankle SocietyFASA and Visual Analogue scale (VAS). Results all patients were followed up for 827 months (mean 22 months). No blood vessels, no nerve injury. At the last follow-up, the AOFAS score increased from (35.0 卤10.1) to (89.8 卤3.8) (t ~ (-26.456) P _ (0.000). The VAS score decreased from (6.6 卤1.9) to (2.5 卤1.3) (t _ (12.427) P _ (0.000), and the ankle flexion angle increased from 29.4 掳卤2.3 掳to 43.4 掳卤1.4 掳(t _ (32.625) P _ (0.000). Excellent 21 cases, good 9 cases, excellent and good rate 100%. Conclusion the debridement of ankle joint under arthroscopy and the management of complications are one of the effective methods for the treatment of posterior impact sign of ankle joint, which has the advantages of minimally invasive, safety, strong pertinence and quick functional recovery after operation.
【作者单位】：皖南医学院附属弋矶山医院关节骨科;蚌埠医学院第二附属医院骨科;
【分类号】：R687.4

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