踝关节镜结合中药外洗治疗20例创伤性踝关节炎的临床观察

Clinical Observation ofankle arthroscopy combined with external medicine wash treatment of traumaticankle arthritis

目的：探讨踝关节镜结合中药外洗治疗创伤性踝关节炎的疗效。方法：将40例创伤性踝关节炎患者随机分为治疗组和对照组，每组20例。均行关节镜检查，明确关节内病变状况，并对相应病变行镜下清理术，其中软骨损伤及退变26例，游离体形成3例，撞击综合征11例。治疗组采用踝关节镜结合中药外洗治疗，对照组仅采用踝关节镜治疗。术后采用美国足踝外科学会（AOFAS）后足踝评分表对踝关节功能状况进行评分。结果：两组有效率比较差异有统计学意义（P〈0．05）；术后平均随访（14．2±8．4）个月（5-24个月），术后关节功能AOFAS评分治疗组改善为（83．4±11．6）分，对照组改善为（76．7±12．4）分，其中主观评分改善更为明显，差异具有统计学意义（P〈0．05）。结论：踝关节镜结合中药外洗治疗创伤性踝关节炎疗效较好，值得在临床推广。

Objective To explore the ankle arthroscopy combined with external medicine wash treatment of traumatic ankle arthritis wash effect. Methods From March 2008 to March 2013 , treated 40 cases of traumatic ankle arthritis after arthroscopic ankle surgery patients , 16 males and 24 females ; aged 15 to 58 years, mean 32 years . Duration of 2 months to 4 years , with an average of 12 months. The 40 patients were randomly divided into treatment group and control group , 20 cases in each group. Underwent arthroscopic examination, a clear situation of intra - articular lesions , and the corresponding lesion debridement , in which cartilage injury and degeneration in 26 cases, 3 cases of free formation , impingement syndrome in 11 cases. The treatment group received a combination of ankle arthroscopy with external medicine wash treatment, the control group, only the use of ankle arthroscopy . American Orthopaedic Foot and Ankle Society after adoption （AOFAS） score sheet after ankle ankle functional status score. Results The two groups have more efficient significant difference （ P 〈 0. 05 ） ; mean follow - up （ 14. 2 ± 8.4） months （ 5 to 24 months ） , postoperative joint function AOFAS score for the treatment group improved （83.4 ± 11.6） points, improving the control group （76.7 ± 12.4） points, which is more subjective scores improved significantly. Statistical analysis showed that the total score difference was significant （ P 〈 0. 05 ） between the two groups. Conclusion Ankle arthroscopy combined with external medicine wash traumatic ankle arthritis better, worthy of promotion.