踝关节镜辅助下改良Brostrom法治疗慢性踝关节不稳25例

Effect and prognosis of modified Brostrom method assisted by ankle arthroscopy in the treatment of 25 cases of chronic ankle instability

目的观察踝关节镜辅助下改良Brostrom法治疗慢性踝关节不稳的疗效。方法回顾性分析2018年1月至2020年6月深圳恒生医院收治的50例慢性踝关节不稳患者的临床资料。根据治疗方法的不同将患者分为研究组与对照组各25例,对照组患者给予传统开放式Brostrom手术治疗,研究组患者给予踝关节镜辅助下改良Brostrom法治疗。比较两组患者术前、术后1周及出院前患者行走时的视觉模拟评分(VAS评分)、美国足踝关节协会(AOFAS)踝-后足评分与术后并发症发生情况。结果两组患者的术前行走时VAS评分比较差异无统计学意义(P>0.05),术后1周及出院前,研究组患者行走时的VAS评分分别为(1.92±0.45)分、(1.59±0.21)分,均明显低于对照组的(3.45±0.78)分、(2.31±0.54)分,差异有统计学意义(P<0.05);两组患者术前AOFAS评分比较差异无统计学意义(P>0.05);术后1周及出院前研究组患者的AOFAS评分分别为(89.92±6.45)分、(91.59±9.21)分,均明显高于对照组的(83.45±5.78)分、(85.31±7.54)分,差异有统计学意义(P<0.05);研究组患者的并发症发生率为4.00%,明显低于对照组患者的24.00%,差异有统计学意义(P<0.05)。结论踝关节镜辅助下改良Brostrom法能够有效提高慢性踝关节不稳患者术后的疗效,改善患者的预后,值得推广应用。

Objective To observe the effect of modified Brostrom method assisted by ankle arthroscopy in the treatment of chronic ankle instability.Methods The clinical data of 50 patients with chronic ankle instability,who admitted to Shenzhen Hengsheng Hospital from January 2018 to June 2020,were analyzed retrospectively.According to the treatment method,the patients were divided into the study group and the control group,with 25 patients in each group.The control group was treated with traditional open Brostrom operation,and the patients in the study group were treated with ankle arthroscopy.The visual analogue scale (VAS),American Orthopaedic Foot and Ankle Association (AO-FAS) Ankle Hindfoot scale,and postoperative complications were compared between the two groups before operation,1week after operation and before discharge.Results There was no significant difference in VAS score before operation between the two groups (P>0.05);one week after operation and before discharge,the VAS scores of the study group were (1.92±0.45) points and (1.59±0.21) points respectively,which were significantly lower than corresponding (3.45±0.78) points and (2.31±0.54) points of the control group (P<0.05);there was no significant difference in preoperative AO-FAS score between the two groups (P>0.05);one week after operation and before discharge,the AOFAS scores of the study group were (89.92±6.45) points and (91.59±9.21) points respectively,which were significantly higher than corresponding (83.45±5.78) points and (85.31±7.54) points of the control group (P<0.05);the incidence of complications in the study group was 4.00%,which was significantly lower than 24.00%in the control group (P<0.05).Conclusion The modified Brostrom method assisted by ankle arthroscopy can effectively improve the postoperative efficacy and prognosis of patients with chronic ankle instability,which is worth promoting in clinical practice.