CAJ | 학술논문

目的介绍应用关节镜技术治疗踝关节不同类型运动创伤性踝关节炎的方法和体会.方法对2008年1月-2010年10月采用踝关节镜下治疗运动创伤性踝关节炎25例,手术前后以美国足踝外科协会(AOFAS)踝-后足评分系统进行评价功能,以前抽屉应力位X线片评估关节稳定性.25例患者进行关节镜检查并进行相应滑膜瘢痕组织切除、软骨面修整、微骨折处理治疗,5例1期行外踝韧带缝合修补术.结果关节镜下可见单纯滑膜炎4例,滑膜炎合并纤维瘢痕组织增生形成撞击综合征10例,胫骨和(或)距骨软骨损伤11例,腓骨端新鲜损伤淤血4例.23例患者获随访,随访时间6～24个月,平均13.5个月.踝-后足评分术前(54.3±6.2)分,术后1个月为(81.5±7.9)分,3个月为(82.9±2.5)分,半年为(83.1±2.1)分,1年为(83.5±3.9)分,差异均有统计学意义(t=13.01,20.58,21.10,19.11,P＜0.05)；术前前抽屉应力位X线片示距骨前移为(15.2±2.5)mm,术后为(3.5±0.2)mm,差异有统计学意义(t=9.33,P＜0.05).患者前抽屉试验和距骨倾斜试验均为阴性.结论踝关节镜创伤小、恢复快,通过关节镜技术对症治疗,踝关节运动创伤后的不适症状可明显得到缓解.
목적 개소응용관절경기술치료과관절불동류형운동창상성과관절염적방법화체회.방법 대2008년1월-2010년10월채용과관절경하치료운동창상성과관절염25례,수술전후이미국족과외과협회(AOFAS)과-후족평분계통진행평개공능,이전추체응력위X선편평고관절은정성.25례환자진행관절경검사병진행상응활막반흔조직절제、연골면수정、미골절처리치료,5례1기행외과인대봉합수보술.결과 관절경하가견단순활막염4례,활막염합병섬유반흔조직증생형성당격종합정10례,경골화(혹)거골연골손상11례,비골단신선손상어혈4례.23례환자획수방,수방시간6～24개월,평균13.5개월.과-후족평분술전(54.3±6.2)분,술후1개월위(81.5±7.9)분,3개월위(82.9±2.5)분,반년위(83.1±2.1)분,1년위(83.5±3.9)분,차이균유통계학의의(t=13.01,20.58,21.10,19.11,P＜0.05)；술전전추체응력위X선편시거골전이위(15.2±2.5)mm,술후위(3.5±0.2)mm,차이유통계학의의(t=9.33,P＜0.05).환자전추체시험화거골경사시험균위음성.결론 과관절경창상소、회복쾌,통과관절경기술대증치료,과관절운동창상후적불괄증상가명현득도완해.
To introduce the methods and experience of arthroscopy treating different types of sports traumatic ankle arthritis.Methods The study involved 25 patents with spots traumatic ankle arthritis treated under ankle arthroscopy from January 2008 to October 2010.American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system was applied to make functional evaluation before and after operation.Also,anterior drawer stress radiographs were used to assess the stability of joint.All patients had arthroscopic examination and received corresponding treatments,including synovial scar tissue resection,cartilage surface trimming,and microfracture management.Five patients underwent stage Ⅰ extramalleolus ligament repair.Results Arthroscopy showed simple synovitis in four patients,impingement syndrome developed from synovitis with fibrous scar tissue formation in 10,tibial or talus cartilage lesions in 11 and congestion of fresh injury of fibular end in four.A total of 23 cases were followed up for average 13.5 months (range,6-24 months).The ankle-hindfoot score was increased from preoperative (54.3 ± 6.2) points to (81.5 ± 7.9) points at 1 month,(82.9 ± 2.5) points at 3 months,( 83.1 + 2.1 ) points at 6 months and ( 83.5 ± 3.9 ) points at 12 months,with statistical differences ( t =13.01,20.58,21.10,19.11 respectively,P＜0.05).The anterior drawer stress radiographs showed that the anterior translation of talus improved from preoperative ( 15.2 ± 2.5 ) mm to postoperative (3.5 ± 0.2 ) mm,with statistical difference ( t =9.33,P ＜ 0.05 ).The anterior drawer test and talus tilt test were both negative for all patients.Concluslons Ankle arthroscopy is characterized by micro trauma and fast recovery.Symptomatic treatment under arthroscopy can obviously relieve the uncomfortable symptoms following sports traumatic ankle arthritis.