Bilgin S Sinan, Köse K Cağri, Adiyaman Sinan, Demirtaş Mehmet
Department of Orthopedics and Traumatology, Division of Hand Surgery, Medicine Faculty of Ankara University, Ankara, Turkey.
Acta Orthop Traumatol Turc. 2004;38(1):23-9.
We evaluated early functional results of arthroscopic surgery in the treatment of ankle pathologies.
A total of 32 patients (17 males, 15 females; mean age 35 years; range 17 to 54 years) underwent arthroscopic surgery for ankle lesions, which included osteochondritis dissecans (n=21), synovitis (n=6), impingement syndrome (n=4), and synovial chondromatosis. Arthroscopic surgery was performed in the left ankle in 15 patients, and in the right ankle in 17 patients. Osteochondral lesions were assessed by the Berndt-Harty, arthroscopic views by the Ferkel-Cheng classification systems. Preoperative and postoperative functional evaluations were made using the Freiburg ankle scoring system. The mean follow-up was 42 months (range 11 to 84 months).
There was no improvement in Freiburg scores within nine weeks in patients with osteochondritis dissecans, whose preoperative mean score was 66. However, at the end of 3.5 months, the Freiburg scores manifested a marked increase to a mean of 88. Functional scores increased from 72 to 90, and from 80 to 95 in patients with synovitis and impingement syndrome, respectively, at the end of nine weeks. The patient with synovial chondromatosis became symptom-free after two months. Complications included breakage of a drill in one patient and development of reflex sympathetic dystrophy in another.
Arthroscopic surgery for ankle lesions decreases surgical morbidity and promotes functional improvement, especially in patients with osteochondritis dissecans, synovitis, and impingement syndrome.
我们评估了关节镜手术治疗踝关节病变的早期功能结果。
共有32例患者（男17例，女15例；平均年龄35岁；年龄范围17至54岁）接受了踝关节病变的关节镜手术，其中包括剥脱性骨软骨炎（n = 21）、滑膜炎（n = 6）、撞击综合征（n = 4）和滑膜软骨瘤病。15例患者在左踝关节进行了关节镜手术，17例患者在右踝关节进行了手术。采用Berndt-Harty法评估骨软骨损伤，采用Ferkel-Cheng分类系统评估关节镜视野。使用弗莱堡踝关节评分系统进行术前和术后功能评估。平均随访42个月（范围11至84个月）。
剥脱性骨软骨炎患者在9周内弗莱堡评分无改善，术前平均评分为66分。然而，在3.5个月末，弗莱堡评分显著提高至平均88分。滑膜炎和撞击综合征患者在9周结束时，功能评分分别从72分提高到90分，从80分提高到95分。滑膜软骨瘤病患者在两个月后症状消失。并发症包括1例患者钻头断裂，另1例患者发生反射性交感神经营养不良。
踝关节病变的关节镜手术可降低手术发病率并促进功能改善，尤其是对于剥脱性骨软骨炎、滑膜炎和撞击综合征患者。
