踝部悬空侧卧漂浮可变体位在踝关节镜前后间室清理术中的应用  

Combined Posterior and Anterior Ankle Arthroscopy Using a Lateral Floating Variable Position with Ankle Suspended

作　　者：李莎 张杰[2] 魏世隽 郑博宇 伍鑫晨 陈燕 Li Sha;Zhang Jie;Wei Shijun;Zheng Boyu;Wu Xinchen;Chen Yan(Department of Operation,General Hospital of Central Theatre Command,Wuhan 430070,China;Hubei University of Medicine,Shiyan 442000,China;Department of Orthopedics,General Hospital of Central Theatre Command,Wuhan 430070,China;Medical College,Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]中部战区总医院手术室,武汉430070 [2]湖北医药学院,湖北十堰442000 [3]中部战区总医院骨科,武汉430070 [4]武汉科技大学医学院,武汉430081

出　　处：《骨科》2024年第6期529-533,共5页ORTHOPAEDICS

基　　金：中国研究型医院学会一般面上项目(Y2024FH-ZHYX11)。

摘　　要：目的探讨踝部悬空侧卧漂浮可变体位在踝关节镜前后间室清理术中的应用及近期疗效。方法回顾性分析2019年10月至2023年2月中部战区总医院收治且获得完整随访资料的57例前后踝撞击综合征病人。根据手术时采用的体位不同分为两组,其中观察组29例采用踝部悬空侧卧漂浮可变体位,对照组28例采用传统的仰卧位中转俯卧位,行关节镜下前后间室联合清理手术。记录并比较两组病人的手术时间、更换体位总耗时、术前体位准备时间、术中更换体位耗时、术中出血量和并发症发生率。末次随访对比两组间美国足踝外科医师协会(AOFAS)踝与后足功能评分和疼痛视觉模拟量表(VAS)评分的差异。结果57例病人获得随访,随访时间为(20.91±2.86)个月(18~28个月)。两组手术时间和出血量之间的差异没有统计学意义(P>0.05)。但在更换体位总耗时、术前体位准备时间、术中更换体位耗时上,两组差异有统计学意义(P<0.05)。两组并发症发生率、末次随访AOFAS评分和VAS评分比较,差异无统计学意义(P>0.05)。结论在踝关节镜前后间室清理术中采用踝部悬空侧卧漂浮可变体位,变换体位更加简便安全,可获得足够的手术操作空间和良好的镜下视野,且无需二次消毒铺单。Objective To explore the short-term clinical outcomes of combined anterior and posterior ankle arthroscopy using a lateral floating variable position with ankle suspended.Methods A retrospective analysis was conducted on 57 patients with combined anterior and posterior ankle impingement syndrome from October 2019 to February 2023 in our hospital.Among them,29 cases in the observation group were subjected to a lateral floating variable position with ankle suspended,while 28 cases in the control group to a traditional supine to prone position and underwent combined anterior and posterior arthroscopic debridement.The surgical time,total changing positions time,preoperative preparation time,intraoperative changing positions time,intraoperative bleeding volume,and complications were recorded and compared between both groups.The American Association of Foot and Ankle Surgeons(AOFAS)ankle and hind foot function scores and the visual analogue scale(VAS)were compared at the final follow-up.Results The follow-up time was(20.91±2.86)months(18-28 months).There was no significant difference in the surgical time and intraoperative bleeding volume between two groups(P>0.05).There was a significant difference in the total changing positions time,preoperative preparation time,intraoperative changing positions time between two groups(P<0.05).No significant difference was documented in the complications between two groups(P>0.05).Similarly,there were no significant difference in the AOFAS score and VAS score at final follow-up between two groups.Conclusion In combined anterior and posterior ankle arthroscopic surgery,the application of a lateral floating variable position with ankle suspended is effective and safe,providing sufficient surgical space and arthroscopic visualization without the need for secondary sterilization.

关 键 词：关节镜 踝关节 踝关节撞击综合征 关节清理术 手术体位 

分 类 号：R687.4[医药卫生—骨科学]