全踝关节镜下神经松解术治疗踝管综合征  

Clinical analysis of ankle arthroscopy technique for treatment of tarsal tunnel syndrome

作　　者：冯仕明[1] 徐柯烽 李成坤[1] 王爱国[1] 张在轶 Feng Shiming;Xu Kefeng;Li Chengkun;Wang Aiguo;Zhang Zaiyi(Department of Hand and Foot Microsurgery,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]江苏徐州市中心医院手足显微外科,221009

出　　处：《中华医学杂志》2018年第37期2995-2998,共4页National Medical Journal of China

基　　金：江苏省青年医学人才项目（QNRC2016393）

摘　　要：目的探讨全踝关节镜下神经松解术治疗踝管综合征的手术方法和临床效果。方法2014年5月至2016年5月，徐州市中心医院手足显微外科收治22例24足踝管综合征患者，其中左侧10足，右侧14足。患者年龄26～57岁，病程4～15个月，平均8．3个月。采用双通道全踝关节镜下神经松解和纤维隔膜切除术治疗。术后采用Pfeiffer疗效评价标准进行评价。结果术后切口均获Ⅰ期愈合，无切口感染发生。术后住院时间2-5d，平均3．7d。术后随访12～24个月，末次随访时，所有患者足踝部的麻木、疼痛等感觉异常均较术前有明显改善。术后依据Pfeiffer提出的疗效评定标准，获优16足，良8足，优良率100％。结论全踝关节镜下神经松解术具有手术创伤小，疗效可靠，术后外观及功能满意等优点，是治疗踝管综合征的有效方法。Objective To explore the effects of ankle arthroscopy technique in treating the tarsal tunnel syndrome. Methods From May 2014 to May 2016, the ankle arthroscopy technique was used for surgical treatment of tarsal tunnel syndrome in the Department of Hand and Foot Microsurgery in Xuzhou Central Hospital. Twenty-two patients with 24 feet with tarsal tunnel syndrome were hospitalized for treatment, with 10 left feet and 14 right feet, aged 26 -57 years. The disease duration ranged from 4 to 15 months （mean 8.3 months）. The dual-portals ankle arthroscopic neurolysis and fiber membrane resection were performed. The Pfeiffer scoring system was used to evaluate the post-operative outcomes. Results Primarily healing of the wound was achieved in all the patients. No postoperative infection was found during the follow-up. The postoperative hospitalization time was 2 to 5 days （ mean 3.7 days）. All patients were followed up for 12 to 24 months. At the final follow-up, all the patients had significant improvement in numbness and pain. According to the Pfeiffer scoring system, the results were excellent in 16 feet, good in 8 feet, with an excellent and good rate of 100%. Conclusion The ankle arthroscopic neurolysis is a safe and easy treatment option for the tarsal tunnel syndrome and provides satisfactory results.

关 键 词：踝管综合征 踝关节镜 神经松解术 显微外科手术 

分 类 号：R658.3[医药卫生—外科学]