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后足撞击症的后踝关节镜检查结果

Outcome of posterior ankle arthroscopy for hindfoot impingement.

作者信息

Willits Kevin, Sonneveld Heleen, Amendola Annunziato, Giffin J Robert, Griffin Sharon, Fowler Peter J

机构信息

Fowler Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London, Ontario, Canada.

出版信息

Arthroscopy. 2008 Feb;24(2):196-202. doi: 10.1016/j.arthro.2007.08.025. Epub 2007 Nov 8.

Abstract

PURPOSE

To provide short-term clinical results of posterior ankle arthroscopy in the treatment of posterior ankle impingement.

METHODS

This was a retrospective evaluation of the clinical outcomes of posterior ankle arthroscopy in a series of patients with posterior ankle pain.

RESULTS

Of 23 patients who underwent 24 posterior ankle arthroscopies between July 1998 and February 2004, 15 patients (mean age, 25 years) with 16 posterior ankle arthroscopies were evaluated at a mean follow-up time of 32 months (range, 6 to 74). Procedures carried out were: excision of os trigonum (11); decompression of prominent posterior talar process (5); tenolysis of flexor hallucis longus (5); removal of loose body (1); osteochondritis dissecans lesion debridement (1); and arthrotomy (1). The average time to return to work was 1 month (range, 0 to 3) and to sports, 5.8 months (range, 1 to 24). Fourteen patients returned to their preinjury level of athletics. Mean Health Survey Short Form (SF-12) scores were 51.80 for the mental component (range, 30.77 to 60.53) and 55.80 for the physical component (range, 44.26 to 63.33). Mean score on the American Orthopaedic Foot and Ankle Society Ankle and Hindfoot Scale was 91 (range, 77 to 100) and on the Lower Extremity Functional Scale was 75 (range, 65 to 80). Documented complications included temporary numbness in the region of the scar in 5 patients and temporary ankle stiffness in 1 patient. There were no permanent neurovascular injuries. All subjects reported significant improvement and indicated that they would undergo the surgery again if needed.

CONCLUSIONS

Functional and clinical evaluations following posterior ankle arthroscopy revealed that all patients were very satisfied. They reported good to excellent health-related quality of life scores, satisfactory functional outcomes, and a high rate of return to sporting activities. Most importantly, no significant complications were encountered. This review suggests that posterior ankle arthroscopy is a safe and effective surgical procedure in the treatment of posterior ankle impingement.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

提供后踝镜治疗后踝撞击症的短期临床结果。

方法

对一系列后踝疼痛患者的后踝镜临床结果进行回顾性评估。

结果

在1998年7月至2004年2月期间接受24次后踝镜检查的23例患者中,对15例(平均年龄25岁)接受16次后踝镜检查的患者进行了评估,平均随访时间为32个月(范围6至74个月)。实施的手术包括:切除距骨三角骨(11例);减压突出的后距骨突(5例);松解拇长屈肌(5例);取出游离体(1例);清创剥脱性骨软骨炎病变(1例);以及切开手术(1例)。平均恢复工作时间为1个月(范围0至3个月),恢复运动时间为5.8个月(范围1至24个月)。14例患者恢复到受伤前的运动水平。健康调查简表(SF - 12)的平均得分,心理维度为51.80(范围30.77至60.53),生理维度为55.80(范围44.26至63.33)。美国矫形足踝协会踝与后足评分的平均得分是91(范围77至100),下肢功能评分的平均得分是75(范围65至80)。记录的并发症包括5例患者瘢痕区域的暂时性麻木和1例患者的暂时性踝关节僵硬。没有永久性神经血管损伤。所有受试者均报告有显著改善,并表示如有需要愿意再次接受手术。

结论

后踝镜检查后的功能和临床评估显示所有患者都非常满意。他们报告了良好至优秀的健康相关生活质量评分、满意的功能结果以及较高的恢复体育活动率。最重要的是,未遇到重大并发症。本综述表明后踝镜检查是治疗后踝撞击症的一种安全有效的手术方法。

证据水平

四级,治疗性病例系列。

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