应用踝关节镜经后方入路治疗距后三角骨综合征的疗效分析

Clinical Outcome of Symptomatic Os Trigonum with Posterior Ankle Arthroscopy

目的探讨踝关节镜经后方入路治疗距后三角骨综合征的临床疗效及安全性。方法 2011-09/2015-12月,对作者医院12例距后三角骨综合征患者进行后方入路踝关节镜手术治疗。其中男9例,女3例;年龄24~57岁,平均30.4岁;右侧8例,左侧4例。手术前后根据美国骨科足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝关节与后足功能评分标准及视觉模拟评分(visual analog scale,VAS)法评价患者的主观疗效满意度。结果12例患者均获有效随访,随访时间为6~26个月,平均15.6个月。术前AOFAS踝关节与后足功能评分为(62.3±7.5)分,术后为(92.4±4.8)分;术前VAS为(5.33±1.25)分,术后为(0.84±0.38)分,术后较术前评分改善均具有统计学意义(P<0.05)。所有患者均未出现血管神经损伤、感染、肌腱粘连及关节僵硬等并发症。术后满意度100%。结论经后方入路踝关节镜治疗距后三角骨综合征临床效果好,并发症少,安全可靠。

Objective To evaluate the clinical results and safety of ankle arthroscopy in the treatment of symptomatic os trigonum.Methods From September 2011 to December 2015,12 patients with symptomatic os trigonum were treated with excision of os trigonum by posterior ankle arthroscopy.There were 9 males and 3females with a mean age of30.4 years（ranged,24-57 years）.The injured right sides were 8 and the lefts were 4.Preoperative and postoperative visual analog scale（VAS）score for pain,American Orthopaedic Foot and Ankle Society（AOFAS）scale was used to analyze the functional results,and patient satisfaction was evaluated after operation as well.Results All patients were followed up and the mean follow-up was 15.6 months（ranged,6-26 months）.Postoperative AOFAS score was significantly higher than preoperative one[（92.4±4.8）vs.（62.3±7.5）,P〈0.05]and postoperative VAS score was significantly higher than preoperative one[（5.33±1.25）vs.（0.84±0.38）,P〈0.05].No severe complications,such as blood vessels and nerve injury,incision infection,tendon adhesion or ankylosis were found.All patients were satisfied with the results.Conclusion Arthroscopic excision of os trigonum is a reliable,safe and effective minimally invasive technique in treating symptomatic os trigonum.