伴腓骨下小骨的踝关节前外侧慢性疼痛的踝关节镜治疗  

Surgical treatment of anterolateral malleolar pain combined with subfibular ossicles by ankle arthroscopy

作　　者：闫旭[1] 胡茂忠[1] 万东东[1] Yan Xu;Hu Maozhong;Wan Dongdong(Department of Orthopedic Surgery,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院骨科,天津300192

出　　处：《中华医学杂志》2021年第39期3253-3256,共4页National Medical Journal of China

摘　　要：评估2017年4月至2019年1月于天津市第一中心医院接受踝关节镜下切除腓骨下小骨结合改良Brostr?m术治疗伴有腓骨下小骨的踝关节外侧疼痛的15例患者的临床效果。其中男6例,女9例,年龄(40±16)岁,术前症状持续平均7.8个月(1.0~27.0个月)。比较术前与术后疼痛视觉模拟评分(VAS),美国骨科足踝关节协会(AOFAS)踝-后足和Karlsson-Peterson(KP)评分的差异,15例患者随访(12.0±0.5)个月。VAS疼痛评分从术前(5.5±1.3)分降至随访时的(1.6±1.1)分,AOFAS评分由(68.0±9.0)分升至(86.5±7.1)分,KP评分从(65.2±14.0)分升至(86.9±8.1)分,三种评分术后改善均具有统计学意义(均P<0.05)。无一例患者出现术后切口不愈合、皮肤坏死、关节内感染等并发症。可见踝关节镜下探查清理、切除腓骨下小骨及距腓前韧带加强修复是治疗该疾病的理想方法,具有创伤小、恢复快等优点。To evaluates the clinical outcome of the ankle arthroscopic resection of subfibula ossicles combined with modified Broström technique for pain on the external malleolus caused by subfibular ossicles in 15 patients from April 2014 to January 2019 treated in the Tianjin First Central Hospital.The patients included 6 males and 9 females,aged from 24 to 56 years,and the symptoms lasted for a mean of 7.8 months(1.0-27.0 months)before the operation.With a 12-month follow-up,the visual analog scale(VAS)pain score,American Orthopedic Foot and Ankle Society(AOFAS)score and Karlsson-Peterson(KP)score were used to assess the clinical outcome.The VAS pain score reduced from 5.5±1.3 to 1.6±1.1,the AOFAS score increased from 68.0±9.0 to 86.5±7.1,and the KP score improved from 65.2±14.0 to 86.9±8.1 after the operation,respectively;and all the three assessment scores improved significantly(all P<0.05).No cases presented postoperative complications such as non-union of the incision,skin necrosis,and infection,etc.This method is an ideal cure for pain on the external malleolus caused by subfibular ossicles,which has the advantages of less trauma and quick recovery.

关 键 词：踝关节 腓骨下小骨 踝关节镜 踝关节撞击症 

分 类 号：R687.4[医药卫生—骨科学]