关节镜下切除症状性距后三角骨的近期临床疗效分析

Short-term clinical efficacy of arthroscopy for symptomatic os trigonum resection

目的探讨踝关节镜下切除症状性距后三角骨的临床疗效。方法 2009年4月至2011年4月,我科采用踝关节镜下切除疼痛性距后三角骨18例,患者均表现为踝关节后侧疼痛,主动及被动跖屈时疼痛加重,术后均获随访,平均随访时间为15(8～24)个月。根据主观和客观评分判断疗效。结果术后患足的美国足踝外科(AOFAS)后踝关节评分[(92.8±3.7)分]显著高于术前[(69.9±2.7)分,t=18.72,P<0.05],主观疼痛程度评分[(1.2±0.8)分]显著低于术前[(4.30±0.55)分,t=21.3,P<0.05]。结论关节镜手术较传统开放手术,有减小创伤、恢复更快、减少并发症以及方便留取病理结果等优势。

Objective To explore the clinical efficacy of arthroscopy for symptomatic os trigonum resection.Methods We assessed the efficacy of arthroscopy for 18 cases of symptomatic os trigonum resection from Feb.2009 to Apr.2011.The 18 patients had ankle pain in the back of the joint,and the pain worsened during active and passive plantar flexion.All the patients were followed up for 8 to 24 months（15 months on average） after operation.According to the subjective and objective scores,the clinic efficacy of arthroscopic resection was evaluated.Results The American Orthopaedic Foot and Ankle Society（AOFAS） hindfoot score of the patients after operation（92.8±3.7） was significantly higher than that before operation（69.9±2.7）（t=18.72,P0.05）,and the postoperative subjective pain score（1.2±0.8） was significantly lower than the preoperative pain score（4.30±0.55）（t=21.3,P0.05）.Conclusion Compared with traditional open operation,arthroscopy has the advantages of reducing trauma and complications,and the patients can recover quickly.