应用关节镜技术诊断及治疗前踝撞击综合征的临床研究

Clinical study on arthroscopy in diagnosis and treatment of anterior ankle impingement syndrome

目的探讨关节镜手术诊断及治疗前踝撞击综合征的临床价值及疗效。方法回顾性分析25例初步诊断为前踝撞击综合征的患者资料,均进行关节镜手术,证实存在前踝软组织撞击或骨性撞击,并进行深度清理,解除撞击因素,比较患者术前与末次随访时的美国足踝外科协会(AOFAS)踝-后足评分与疼痛视觉模拟评分法(VAS)评分,评价临床疗效。结果所有患者均获得随访,平均随访2~3年;所有患者切口一期愈合,未出现感染;患者末次随访时VAS评分为(1.50±0.64)分,显著低于术前的(6.88±0.72)分(P<0.05);患者末次随访时AOFAS踝-后足评分为(90.14±4.04)分,显著高于术前的(49.16±7.28)分(P<0.05);末次随访时,本组患者AOFAS踝-后足评分优良率为92.00%。结论关节镜技术对于前踝撞击综合征尤其是前踝软组织撞击综合征的诊断具有重要意义。关节镜手术治疗前踝撞击综合征创伤小,对踝关节解剖结构破坏小,康复快,减轻了患者的痛苦,具有很好的临床疗效。

Objective To explore the clinical value and effect of arthroscopic surgery in the diagnosis and treatment of anterior ankle impingement syndrome.Methods The clinical data of 28 patients who were initially diagnosed as anterior ankle impingement syndrome was reviewed.Arthroscopic surgery was performed in all the patients and the presence of anterior ankle soft tissue impingement or bone impingement was confirmed,and deep cleaning was performed to remove the impact factors.Visual Analogue Scale(VAS)scores and ankle posterior foot scores of American Orthopedic Foot Ankle Society(AOFAS)were compared before and at the last follow-up to evaluate the clinical effects of the patients.Results All patients were successfully followed up,with an average of 2 to 3 years.All patients healed in the first stage of incision,without incision infection.At the last follow-up,the VAS score was(1.50±0.64)points,which was significantly lower than(6.88±0.72)points before operation(P<0.05);the ankle posterior foot score of AOFAS was(90.14±4.04)points,which was significantly higher than(49.16±7.28)points before operation(P<0.05).The excellent and good rate of ankle posterior foot score of AOFAS was 92.00%.Conclusion Arthroscopic technique is of great significance in the diagnosis of anterior ankle impingement syndrome,especially for the anterior ankle soft tissue impingement syndrome.Arthroscopic surgery has less trauma and destruction to the ankle-anatomical structure in the treatment of anterior ankle-impingement syndrome.Meanwhile,it can promote recovery,alleviate pain,and has better clinical effect.