关节镜微创治疗踝关节撞击综合征的疗效

The effect of arthroscopic therapy for ankle joint impingement syndrome

目的探讨关节镜微创手术治疗踝关节撞击综合征的疗效。方法关节镜手术治疗踝关节撞击综合征46例,男32例,女14例,平均年龄24岁(18～32岁)。左踝20例,右踝26例。运动员及体育爱好者16例,军人15例,学生11例,舞蹈演员4例。前踝撞击综合征37例,后踝撞击综合征9例。关节镜下行前后踝或距骨骨赘磨削,刨削清理增生肥厚的纤维瘢痕和滑膜组织,清除退变剥脱的软骨碎屑。结果术后得到随访41例,失访5例。平均随访3.5年(2.5～7.6年)。46例患者中,37例踝关节疼痛肿胀消失、背伸跖屈活动度正常、功能恢复到伤前水平,4例踝关节背伸活动轻度受限,活动后肿胀疼痛。踝关节间隙无变窄。根据踝关节疗效评定标准[1]进行疗效评估,优70.7%(29例),良17.1%(7例),可12.2%(5例),优良率87.8%。结论关节镜下微创手术治疗踝关节撞击综合征,操作简便,安全有效,创伤小,痛苦少,术后功能恢复快。

Objective To study the effect of arthroscopic therapy for the ankle joint impingement syndrome （AJIS）. Method Forty-six patients with AJIS underwent arthroscopic surgery, among them 32 males and 14 females, mean aged 24 years（range, 18 to 32 years old）. In this group, there were 16 athletes, 15 soldiers, 11 students and 4 dancers. Twenty patients had left ankle involvement and 26 patients had right ankle involved. Front AJIS was found in 37 cases and the hock AJIS 9 cases. Arthroscopic intervention included removing osteophytes, dibriding fabric scars and synovial membrane tissues and removing osteochondral fragments. Results Forty-one cases were followed-up for average 3.5 years （2.5-7.6 years）. Without joint space narrowing, the group showed significantly better scores of pain, swelling, function of the motion and ability to work after arthroscopic therapy. The excellent rate was 70.7% （29 cases）, good 17.1% （7 cases）, and fair 12.2% （5 cases）. The good and excellent rate was 87.8%. Conclusion Compared with open techniques, arthroscopic treatment with ankle joint impingement syndrome is an effective, simple, safe and minimally invasive method.