CAJ | 학술논문

背景:距后三角骨损伤是踝关节后方撞击症的主要原因之一,常需手术切除.目的:探讨踝关节后方入路关节镜下切除损伤距后三角骨的解剖学特点及临床疗效.方法:2010年8月至2013年10月,10例距后三角骨损伤患者接受踝关节镜手术治疗.男7例,女3例;年龄17~55岁,平均39.2岁.致伤原因:运动伤6例,无明确外伤史4例.左侧4例,右侧6例.手术前后根据美国矫形足踝协会(AO-FAS)评分标准对患足功能进行评估.结果:10例患者随访时间13~35个月,平均24个月.AOFAS评分从术前(75.6±3.0)分提高到术后(95.8±2.0)分(t=21.02,P<0.001).随访时未出现血管、神经损伤,伤口或关节感染等并发症.结论:经后方入路踝关节镜治疗距后三角骨损伤临床效果好,并发症少.熟悉踝关节后方解剖结构并正确应用关节镜技术是减少副损伤的关键.
배경:거후삼각골손상시과관절후방당격증적주요원인지일,상수수술절제.목적:탐토과관절후방입로관절경하절제손상거후삼각골적해부학특점급림상료효.방법:2010년8월지2013년10월,10례거후삼각골손상환자접수과관절경수술치료.남7례,녀3례;년령17~55세,평균39.2세.치상원인:운동상6례,무명학외상사4례.좌측4례,우측6례.수술전후근거미국교형족과협회(AO-FAS)평분표준대환족공능진행평고.결과:10례환자수방시간13~35개월,평균24개월.AOFAS평분종술전(75.6±3.0)분제고도술후(95.8±2.0)분(t=21.02,P<0.001).수방시미출현혈관、신경손상,상구혹관절감염등병발증.결론:경후방입로과관절경치료거후삼각골손상림상효과호,병발증소.숙실과관절후방해부결구병정학응용관절경기술시감소부손상적관건.
Background:Symptomatic os trigonum is one of the main reasons of ankle posterior impingement,and it usually needs exci-sion. Objective:To evaluate anatomic features and therapeutic effects of posterior arthroscopic excision of symptomatic os trigo-num. Methods:Ten patients with symptomatic os trigonum underwent posterior arthroscopic excision of os trigonum. There were 7 males and 3 females with a mean age of 39.2 years (range, 17-55 years). The injuries resulted from exercise in 6 cases. There was no trauma history in 4 cases. The left was injured in 4 feet and the right was involved in 6 feet. Clinical outcomes were evaluated by the ankle and hindfoot scoring system of American Orthopaedic Foot and Ankle Society (AOFAS) before and after the operation. Results:The mean duration of follow-up was 24 months (range, 13-35 months). Postoperative AOFAS score was significant-ly higher than preoperative one (75.6 ± 3.0 vs 95.8 ± 2.0, t=21.02, P<0.001). No severe complications, such as vascular or nerve injury, incision or joint infection were found. Conclusions:Posterior arthroscopic excision of os trigonumis is an effective method for symptomatic os trigonum. It is very important to master anatomic structures of the posterior ankle for arthroscopic technique.