目的：探讨关节镜在踝关节骨性撞击综合症中的诊治效果。方法收集18例踝关节骨性撞击综合征患者,行关节镜检查及镜下手术,其中男14例,女4例,平均年龄27.6岁(17~55岁)。14例患者有踝关节扭伤史,踝关节疼痛持续时间7~66个月,平均22.5个月。所有患者都有踝关节前方疼痛、关节活动度降低、肿胀、踝关节撞击试验阳性。关节镜下治疗包括清除骨赘、清除疤痕组织和滑膜组织,去除骨软骨碎片,修整损伤的关节软骨面。结果18例患者获5~18个月随访,平均10个月,术后踝关节功能评估根据美国足踝外科协会足踝关节评分系统(AOFAS)：优10例；良6例；中2例；优良率88.9%。1例出现足背麻木,1例出现足背动脉损伤。结论踝关节镜是治疗踝关节骨性撞击综合征的有效方法。%Objective To explore the effectiveness of Microinvasive arthroscopy for bony ankle impingement syn-drome. Methods 18 patients with bony ankle impingement syndrome were treated with arthroscopy surgery. Among them, there were 14 males and 4 females with an average age of 27. 6 years(range,16~55 years). Fourteen patients had a history of obvious ankle sprains. The disease duration was 7~66 months(mean,22. 5 months). All cases had ankle pain,limitation of activity,and positive results of ankle impact test. Arthroscopic intervention included removing osteophytes,debriding fabric scars and synovial membrane tissues,and removing osteochondral fragments,mending the damage of articular cartilage surface. Results All patients were followed for 5~18(mean 10. 0) months. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society ( AOFAS) . There were 10 cases in excellent,6 cases in good grade,and 2 cases in medium grade. The excellent and good rate was up to 88. 9%. Among the 18 cases,there were no complications such as postoperative infection, neurologic damage,and injury of blood vessel. One case showed foot back numb,1 case had dorsalis pedis artery injury. Conclusion It showed that arthroscopy surgery is an effective therapeutic method for bony ankle impingement syndrome.
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