关节镜在外踝钢板螺钉取出术中的应用

Application of arthroscopy in removal of lateral malleolus internal fixation

[目的]探讨关节镜技术在外踝钢板螺钉取出术中的应用效果。[方法]2014年12月~2016年11月,对29例外踝骨折术后的患者行关节镜下钢板螺钉取出术。内固定取出术前后行手术瘢痕长度测量及踝关节AOFAS评分。[结果]所有病例均在关节镜下完整取出了钢板螺钉。内固定取出术后3个月手术瘢痕长度为(2.75±0.49)cm(t=25.154),与初次骨折内固定手术后3个月的手术瘢痕长度比较,差异有统计学意义。内固定取出术后3个月踝关节AOFAS评分为:疼痛评分(30.83±3.24)分(t=12.535),功能评分(40.48±3.50)分(t=3.889),与内固定取出术前踝关节AOFAS评分比较,差异有统计学意义;对线评分(9.48±1.55分)(t=0.573),与内固定取出术前踝关节AOFAS评分比较,差异无统计学意义。[结论]关节镜技术作为一项重要的骨科微创技术,可应用于外踝钢板螺钉取出术。

[Objective] To develop a clinical technique for removal of lateral malleolus internal fixation hy arthroscopy. [Methods] From Dee 2014 to Nov 2016, we removed the lateral malleolus internal fixation by arthroseopy in 29 patients. We measured the length of incision scars before and after internal fixators removed, compared AOFAS-ankle scores before and 3 months after the implant removed surgery. [Results] All the 29 patients had lateral malleolus internal fixation removed per- tectly by arthroscopy. At 3 months after the removed the length of the scars were 2.75±0.49cm, which was statistically shortened than the primary surgical incision （t=25.154, P〈0.01 ） . The AOFAS scores at 3 months after ttle remove surgery were marked as 30.83±3.24 in pain （t=12.535, P〈0.01 ） and 40.48±3.50 in function （t=3.889, P〈0.05 ） , which statistically improved com- pared with those ones before the fixation removed surgery. However, AOFAS alignment scores of 9.48± 1.55 at 3 months after the fixation removed was no significant difference to that before the surgery （t=0.573, P 〉0.05） . [Conclusion] As a mini- real invasive technique, arthroscopic technique can be used in the surgery of removal of lateral malleolus internal fixation.