中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
17期
34-35
,共2页
关节镜%踝关节撞击综合征
關節鏡%踝關節撞擊綜閤徵
관절경%과관절당격종합정
Arthroscope%Ankle joint Impingement syndrome
目的探讨关节镜下诊治踝关节撞击综合征的临床疗效。方法2008年8月至2010年8月，收治28例踝关节撞击综合征的患者。男18例，女10例；年龄18~42岁，平均28岁，踝关节前外侧和前侧有局限性压痛；关节背伸-20°~-5°，平均-10.7°；跖屈30°~40°，平均34.5°。根据美国矫形足踝协会（AOFAS）踝与后足评分标准，总分为（47.82±9.24）分，疼痛评分为（7.36±1.02）分。X线片检查示胫骨前缘和距骨均有骨赘增生，MRI显示20例有胫、距关节软骨面损伤。关节镜下行胫骨前缘或距骨骨赘磨削，刨削清理前外踝的瘢痕和增生滑膜组织，清除剥脱软骨。结果术后患者切口均Ⅰ期愈合。28例均获随访，随访时间10~24个月，平均16个月。末次随访时，22例踝关节活动基本恢复正常，背伸达15°~25°，平均19.8°；跖屈35°~45°，平均41.7°。4例轻度受限，背伸5°~15°，平均7.3°；跖屈35°~45°，平均38.5°。2例持续行走3~4h后踝关节出现疼痛，关节活动轻度受限，背伸0°~5°，平均2.6°；跖屈35°~40°，平均37.5°。AOFAS踝与后足评分总分为（88.75±9.65）分，与术前比较差异有统计学意义（t=21.962，P=0.000）；疼痛评分为（1.42±1.26）分，与术前比较差异有统计学意义（t=16.762，P=0.000）。结论关节镜下治疗踝关节撞击综合征征手术操作简便，可获得较好疗效。
目的探討關節鏡下診治踝關節撞擊綜閤徵的臨床療效。方法2008年8月至2010年8月，收治28例踝關節撞擊綜閤徵的患者。男18例，女10例；年齡18~42歲，平均28歲，踝關節前外側和前側有跼限性壓痛；關節揹伸-20°~-5°，平均-10.7°；蹠屈30°~40°，平均34.5°。根據美國矯形足踝協會（AOFAS）踝與後足評分標準，總分為（47.82±9.24）分，疼痛評分為（7.36±1.02）分。X線片檢查示脛骨前緣和距骨均有骨贅增生，MRI顯示20例有脛、距關節軟骨麵損傷。關節鏡下行脛骨前緣或距骨骨贅磨削，鑤削清理前外踝的瘢痕和增生滑膜組織，清除剝脫軟骨。結果術後患者切口均Ⅰ期愈閤。28例均穫隨訪，隨訪時間10~24箇月，平均16箇月。末次隨訪時，22例踝關節活動基本恢複正常，揹伸達15°~25°，平均19.8°；蹠屈35°~45°，平均41.7°。4例輕度受限，揹伸5°~15°，平均7.3°；蹠屈35°~45°，平均38.5°。2例持續行走3~4h後踝關節齣現疼痛，關節活動輕度受限，揹伸0°~5°，平均2.6°；蹠屈35°~40°，平均37.5°。AOFAS踝與後足評分總分為（88.75±9.65）分，與術前比較差異有統計學意義（t=21.962，P=0.000）；疼痛評分為（1.42±1.26）分，與術前比較差異有統計學意義（t=16.762，P=0.000）。結論關節鏡下治療踝關節撞擊綜閤徵徵手術操作簡便，可穫得較好療效。
목적탐토관절경하진치과관절당격종합정적림상료효。방법2008년8월지2010년8월，수치28례과관절당격종합정적환자。남18례，녀10례；년령18~42세，평균28세，과관절전외측화전측유국한성압통；관절배신-20°~-5°，평균-10.7°；척굴30°~40°，평균34.5°。근거미국교형족과협회（AOFAS）과여후족평분표준，총분위（47.82±9.24）분，동통평분위（7.36±1.02）분。X선편검사시경골전연화거골균유골췌증생，MRI현시20례유경、거관절연골면손상。관절경하행경골전연혹거골골췌마삭，포삭청리전외과적반흔화증생활막조직，청제박탈연골。결과술후환자절구균Ⅰ기유합。28례균획수방，수방시간10~24개월，평균16개월。말차수방시，22례과관절활동기본회복정상，배신체15°~25°，평균19.8°；척굴35°~45°，평균41.7°。4례경도수한，배신5°~15°，평균7.3°；척굴35°~45°，평균38.5°。2례지속행주3~4h후과관절출현동통，관절활동경도수한，배신0°~5°，평균2.6°；척굴35°~40°，평균37.5°。AOFAS과여후족평분총분위（88.75±9.65）분，여술전비교차이유통계학의의（t=21.962，P=0.000）；동통평분위（1.42±1.26）분，여술전비교차이유통계학의의（t=16.762，P=0.000）。결론관절경하치료과관절당격종합정정수술조작간편，가획득교호료효。
Objective To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome. Methods Between August 2008 and August 2010, 28 patients with ankle joint impingement syndrome were treated. Among them, there were 18 males and 10 females with an average age of 28 years (range, 18 to 42 years). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from-20° to-5° (mean-10.7°), and the palmar lfexion was 30°-40° (mean 34.5°). The total score was (47.82±9.24) and the pain score was (7.36±1.02) before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray iflms showed osteophyte formation in anterior tibia and talus;MRI showed cartilage injury in 20 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Results All incisions healed primarily. Twenty-eight cases were followed up 10-24 months (mean 16 months). At last follow-up, 22 patients had normal range of motion (ROM);the dorsal extension was 15°-25° (mean 19.8°) and the palmar lfexion was 35°-45° (mean 41.7°). Four patients had mild limited ROM;the dorsal extension was 5°-15° (mean 7.3°) and the palmar lfexion was 35°-45° (mean 38.5°). Two patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours);the dorsal extension was 0°-5° (mean 2.6°) and the palmar lfexion was 35°-40° (mean 37.5°). The total score was (88.75±9.65) and the pain score was (1.42±1.26) after operation according to AOFAS ankle and hindfoot score system, showing signiifcant differences when compared with preoperative ones (t=21.962, P=0.000;t=16.762, P=0.000). Conclusion Arthroscopic treatment of ankle joint impingement syndrome is an effective, simple, and safe method.
