微创医学

目的探讨关节镜治疗踝关节前方骨性撞击的疗效。方法对踝关节前方撞击患者17例在踝关节镜下，采用陈旧骨折片取出、骨赘切除、游离体取出、滑膜清理等方法治疗，观察疗效。结果病例均获得12～16个月随访，平均随访时间为12.6个月。患者术后1个月、6个月、12个月的改良Mcguire踝关节评分分别为（80.6±3.7）分、（87.1±2.7）分、（90.4±2.7）分，均明显高于术前的（58.9±5.8）分，差异有统计学意义（P＜0.05）。术后1个月、6个月、12个月Mazur踝关节评分分别为（81.7±3.4）分、（86.7±3.1）分、（89.9±2.6）分，均明显高于术前的（60.3±5.7）分，手术前后比较，差异有统计学意义（P＜0.05）。结论踝关节镜下行前踝撞击部分骨片取出、增生骨质切除、游离体取出、滑膜清理治疗创伤小，并发症少，利于患者早期恢复，是治疗踝关节前方撞击的有效治疗方法。

ObjectiveTo investigate the efficacy of ankle arthroscopy in treatment of ankle impingement syndrome. MethodsSeventeen patients with ankle impingement syndrome were treated under ankle arthroscopy, using the method of removal of old bone fragment, excision of osteophytes, removal of loose bodies, cleanup of synovial membrane. ResultsAll patients were followed up from 12 to 16 months, with an average follow-up time of 12.6 months. The improved Mcguire ankle scores of patients at 1, 6, 12 month after surgery were (80.6±3.7) points, (87.1±2.7) points, (90.4±2.7) points, all significantly higher than the preoperative (58.9±5.8) points, and the difference was statistically significant (P＜0.05). The Mazur ankle scores of patients at 1, 6, 12 month after surgery were (81.7±3.4) points, (86.7±3.1) points, (89.9±2.6) points, all significantly higher than the preoperative (60.3±5.7) points, and the difference before and after surgery was statistically significant (P＜0.05). ConclusionThe treatment using removal of old bone fragment, excision of osteophytes, removal of loose bodies, cleanup of synovial membrane under ankle arthroscopy on the ankle impingement section, has less trauma and fewer complications, be beneficial to the early recovery of patients, which is an effective treatment for ankle impingement syndrome.