关节镜治疗后踝撞击征的临床观察

Clinical observation of arthroscopy for posterior ankle impingement

目的 ：观察后踝关节镜治疗后踝撞击征的临床效果。方法 ：自2013年1月至2014年12月,采用后方双入路后踝关节镜治疗34例后踝撞击征患者,其中男20例,女14例;年龄29~62岁,平均42.2岁。采用VAS视觉模拟评分比较治疗前及治疗后12个月关节疼痛情况,并采用AOFAS踝后足评分进行踝关节功能评价。结果：所有病例获12个月随访,切口愈合良好,无伤口并发症。术中发现34例骨性撞击和19例软组织撞击。手术时间20~35 min,平均（25.6±5.2）min;术后2、6和12个月后踝撞击征呈阴性。术后12个月的VAS视觉模拟评分1.2±1.3明显优于术前的4.6±1.0（P〈0.05）。术后12个月的AOFAS踝后足评分84.7±6.5明显高于术前的62.7±8.9。结论：采用关节镜治疗后踝撞击征可以缓解疼痛,改善功能,手术时间较短,取得了良好的临床效果。

Objective：To observe clinical effects of arthroscopy for posterior ankle impingement. Methods：From January2013 to December 2014,34 patients with posterior ankle impingement were performed ankle arthroscopy with double passage,including 20 males and 14 females aged from 29 to 62 years old with average of 42.2 years old. VAS score were applied for evaluate joint pain before operation and 12 months after operation,AOFAS sore were used to assess ankle joint function. Results：All patients were followed up with 12 months,and incision were healed well,no complications occurred. Thirty four patients were bony impingement and 19 patients were soft tissue impingement. Operation time ranged from 20 to 35 min with an average of（25.6±5.2）min. The posterior ankle impingement test of all patients was negative after operation. VAS score at 12 months after operation（1.2±1.3） was significantly higher than that of before operation（4.6±1.0）. AOFAS score at 12 months after operation（ 84.7±6.5） was also obvious higher than that of before operation（62.7±8.9）. Conclusion：Arthroscopy for posterior ankle impingement could relieve pain and improve function of ankle,shorten operative time,and it has a good clinical effect.