Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
Arthroscopy. 2010 Mar;26(3):384-90. doi: 10.1016/j.arthro.2009.08.029.
To compare the clinical results of a consecutive series of 43 cases of excision of a symptomatic os trigonum performed with an open versus hindfoot endoscopic technique.
From 1994 to 2007, 43 patients underwent a symptomatic os trigonum excision. A subjective satisfaction questionnaire and a visual analog scale score for pain were obtained, and the American Orthopaedic Foot & Ankle Society ankle and hindfoot score and the time to return to previous sports level were determined in 41 of 43 patients at follow up. Of the ankles, 16 had an open os trigonum excision and 25 had hindfoot endoscopic surgery. Group A (16 ankles, open surgery) and group B (25 ankles, endoscopic excision) were comparable concerning age, sex, profession, and concomitant injury of the ankle.
At follow-up evaluation (12 to 86 months after surgery), group B had a significantly shorter mean time to return to previous sports level. There was no difference in postoperative visual analog scale score, American Orthopaedic Foot & Ankle Society score, subjective satisfaction rating, or rating of sensory nerve loss between the 2 groups.
Both open surgery and hindfoot endoscopic excision of a symptomatic os trigonum were effective and safe. Patients with an endoscopic excision had a shorter time to return to previous sports level.
Level IV, therapeutic case series.
比较连续 43 例症状性三角骨切除术的临床结果，分别采用开放式和后足内镜技术。
1994 年至 2007 年，43 例患者接受了症状性三角骨切除术。在随访中，43 例患者中的 41 例获得了主观满意度问卷和疼痛视觉模拟评分，并确定了美国矫形足踝协会踝关节和后足评分以及恢复到以前运动水平的时间。在踝关节中，16 例采用开放式三角骨切除术，25 例采用后足内镜手术。A 组（16 例踝关节，开放式手术）和 B 组（25 例踝关节，内镜切除）在年龄、性别、职业和踝关节伴发损伤方面具有可比性。
在随访评估（术后 12 至 86 个月）时，B 组恢复到以前运动水平的平均时间明显缩短。两组间术后视觉模拟评分、美国矫形足踝协会评分、主观满意度评分或感觉神经损失评分无差异。
开放式手术和后足内镜切除症状性三角骨均有效且安全。内镜切除组患者恢复到以前运动水平的时间更短。
IV 级，治疗性病例系列。
