创伤性踝关节病变的关节镜诊治

目的对创伤性踝关节疼痛关节镜下的诊断和治疗进行初步探讨。方法43例病程半年以上创伤性踝关节疼痛患者行关节镜检查,并进行治疗。结果镜检下与关节疼痛有关病理类型:(1)关节不稳定征(外侧和下胫腓联合韧带损伤);(2)撞击征(前踝骨赘和前外侧软组织损伤);(3)软骨和骨软骨骨折;(4)非特异性骨关节炎和(或)滑膜炎。作镜下关节内清理、关节软骨面修整、骨赘切除、纤维束带切除等,术后关节腔内注射透明质酸钠和关节功能锻炼。术后随访25例,优10例,良13例,可2例,优良率92.0%。结论踝关节镜对诊断和治疗创伤性踝关节疼痛有重要价值。

Objective To explore the application of arthroscopie surgery for diagnosing and treating the traumatic ankle pain. Methods 43 patients of traumatic ankle pain with a history of above 0.5 years were treated with arthroscopic surgery. The pathology changes of this group were classified into four types：（1）Instabilities （lateral and syndesmotic injury）（2）Impingements（anterior osteophytes and anterolateral soft- tissue injury）（3）Articular lesions （chondral and osteochondral fracture） （4）Nonspecific osteoarthritis with or without synovitis. The anhroscopic surgery included in debridement, repairing articular cartilage cutting the osteophyte and resaction of fiberal band. The joint cavity was injected with HA and early exercise of joint were encouraged postoperatively . Results 25 cases were followed up more than six months. 10 of them were excellent in recovery , 13 patients were good and 2 cases were fair. The satisfactory rate was 92% （23cases）. Conclusions Arthroscopic surgery has clinical value in the diagnosis and treatment of traumatic ankle pain.