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踝关节镜手术的并发症。

Complications in ankle arthroscopy.

机构信息

Department of Orthopaedic Surgery, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1420-31. doi: 10.1007/s00167-012-2063-x. Epub 2012 Jun 5.

Abstract

PURPOSE

To determine the complication rate for ankle arthroscopy.

METHODS

A review of a consecutive series of patients undergoing ankle arthroscopy in our hospital between 1987 and 2006 was undertaken. Anterior ankle arthroscopy was performed by means of a 2-portal dorsiflexion method with intermittent soft tissue distraction. Posterior ankle arthroscopy was performed by means of a two-portal hindfoot approach. Complications were registered in a prospective national registration system. Apart from this complication registry, patient records, outpatient charts and operative reports were reviewed. Patients with a complication were asked to visit our hospital for clinical examination and assessment of permanent damage and persisting complaints.

RESULTS

An overall complication rate of 3.5% in 1,305 procedures was found. Neurological complications (1.9%) were related to portal placement. Age was a significant risk factor for the occurrence of complications. Most complications were transient and resolved within 6 months. Complications did not lead to functional limitations. Residual complaints did not influence daily activities.

CONCLUSIONS

Our complication rate is less than half of what has been reported in literature (3.5 vs 10.3%). The use of the dorsiflexion method for anterior ankle arthroscopy can prevent a significant number of complications. Posterior ankle arthroscopy by means of a two-portal hindfoot approach is a safe procedure with a complication rate that compares favourably to that of anterior ankle arthroscopy.

LEVEL OF EVIDENCE

Retrospective prognostic study, Level II.

摘要

目的

确定踝关节镜检查的并发症发生率。

方法

对 1987 年至 2006 年期间在我院行踝关节镜检查的连续患者系列进行回顾性研究。采用 2 个前向跖屈入路的方法进行前踝关节镜检查,间歇性软组织牵开。后踝关节镜检查采用双后足入路。并发症在一个前瞻性国家登记系统中登记。除了该并发症登记处,还回顾了患者记录、门诊图表和手术报告。对有并发症的患者进行临床检查,并评估永久性损伤和持续存在的并发症,邀请他们到我院就诊。

结果

在 1305 例手术中,总的并发症发生率为 3.5%。神经并发症(1.9%)与入路部位有关。年龄是发生并发症的一个显著危险因素。大多数并发症是短暂的,在 6 个月内得到解决。并发症并未导致功能受限。残留的抱怨并没有影响日常生活活动。

结论

我们的并发症发生率低于文献报道的一半(3.5%比 10.3%)。采用跖屈法进行前踝关节镜检查可以预防许多并发症。通过双后足入路进行后踝关节镜检查是一种安全的手术,其并发症发生率与前踝关节镜检查相当。

证据水平

回顾性预后研究,II 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316b/3402678/05cd566b2e66/167_2012_2063_Fig1_HTML.jpg

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