| 关节镜治疗踝关节不稳合并前内侧撞击综合征 |
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Received:September 26, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈城 |
CHEN Cheng |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 李学谦 |
LI Xue-qian |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 傅紹菱 |
FU Shao-ling |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 王诚 |
WANG Cheng |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 苏琰 |
SU Yan |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 薛剑锋 |
XUE Jian-feng |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 邹剑 |
ZOU Jian |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 梅国华 |
MEI Guo-hua |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 顾文奇 |
GU Wen-qi |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 宋国勋 |
SONG Guo-xun |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
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| 施忠民 |
SHI Zhong-min |
上海交通大学附属第六人民医院骨科-足踝外科, 上海 200233 |
Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China |
18930177323@163.com |
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| 期刊信息：《中国骨伤》2022年35卷，第3期，第238-242页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.008 |
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目的: 探讨关节镜治疗踝关节不稳合并前内侧撞击综合征的手术技巧及疗效。
方法: 回顾性分析2019年2月至2020年8月收治的13例踝关节不稳合并前内侧撞击综合征患者。男10例，女3例；年龄（40.0±15.1）岁；病程（44.1±33.2）个月。所有患者有明确扭伤史，MRI证实踝关节距腓前韧带损伤，踝关节背伸时存在前内侧疼痛、压痛。所有患者采用踝关节镜下踝关节清理联合Broströ；m-Gould手术进行治疗。对患者术前及随访期间疼痛视觉模拟评分（visual analogue scale，VAS）和美国足踝外科协会踝与后足评分（American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale，AOFAS-AH）进行评估。
结果: 13例均顺利完成手术，手术时间60~90 min。所有患者手术切口甲级愈合，未发生切口感染、皮肤坏死及神经血管损伤等并发症。13例均获得随访，随访时间（18.1±4.7）个月。末次随访时患者VAS评分（1.2±1.1）分，较术前（4.8±1.5）分下降（P<0.05）；末次随访时AOFAS-AH评分（94.2±5.1）分，较术前（65.5±11.5）分升高（P<0.05）。所有患者步态均正常，无不稳或撞击复发。
结论: 临床上踝关节不稳合并的前内侧撞击综合征容易被忽视，此类前内侧撞击综合征多与距骨颈背内侧骨赘撞击相关，关节镜可以一并处理踝关节不稳合并前内侧撞击综合征，疗效确切，微创安全。 |
| [关键词]:骨赘 关节不稳定性 关节镜 |
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| Arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome |
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Abstract:
Objective: To investigate the surgical skills and clinical curative results of arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome.
Methods: From February 2019 to August 2020,13 patients with ankle instability combined with anteromedial impingement were retrospectively analyzed. There were 10 males and 3 females with age of (40.0±15.1) years old. The course of disease was(44.1±33.2) months. All patients had history of ankle sprain. MRI showed the injury of anterior talofibular ligament. All patients had anteromedial pain and pressing pain when ankle dorsiflexion. All patients were treated with ankle debridement and Broström-Gould surgery under ankle arthroscopic. Postoperative results were evaluated by VAS(visual analogue scale) and AOFAS-AH(American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale,AOFAS-AH).
Results: All 13 patients completed the surgery successfully with an operative time of 60 to 90 minutes. All the surgical incisions healed by first intention,and no complications such as incision infection,skin necrosis and neurovascular injury. Follow-up time was (18.1±4.7) months. At the latest follow-up,the VAS score was 1.2±1.1,which was significantly lower than the preoperative score 4.8±1.5 (P<0.05);the AOFAS-AH score 94.2±5.1 was significantly higher than the preoperative score 65.5±11.5 (P<0.05). The AOFAS-AH score at the final follow-up ranged from 84 to 100. All patients walked with normal gait without ankle instability or impingement recurrence.
Conclusion: Ankle anteromedial impingement syndrome combined with ankle instability is easy to be ignored clinically. Such kind of anteromedial impingement syndrome is mostly related to osteophyte at dorsal medial talar neck. Arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome has satisfactory curative effect with safety and minimal injury. |
| KEYWORDS:Osteophyte Joint instability Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈城,李学谦,傅紹菱,王诚,苏琰,薛剑锋,邹剑,梅国华,顾文奇,宋国勋,施忠民.关节镜治疗踝关节不稳合并前内侧撞击综合征[J].中国骨伤,2022,35(3):238~242 |
| 英文格式: | CHEN Cheng,LI Xue-qian,FU Shao-ling,WANG Cheng,SU Yan,XUE Jian-feng,ZOU Jian,MEI Guo-hua,GU Wen-qi,SONG Guo-xun,SHI Zhong-min.Arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):238~242 |
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