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关节镜在踝关节功能不稳定治疗中的作用。

The role of arthroscopy in the treatment of functional instability of the ankle.

机构信息

Department of Trauma and Orthopaedics, King's Mill Hospital, Mansfield Road, Sutton in Ashfield, Nottinghamshire NG17 4JL, UK.

出版信息

Foot Ankle Surg. 2013 Dec;19(4):273-5. doi: 10.1016/j.fas.2013.06.008. Epub 2013 Jul 15.

Abstract

BACKGROUND

Ankle sprains are common, the majority resolving with functional rehabilitation. Some patients are left with symptoms of functional instability (FI). Ankle arthroscopy in those with symptoms of FI is not well covered in the literature. Our aim was to assess its role in FI of the ankle.

METHODS

Retrospective case note analysis of patients with FI following an ankle sprain from 2005 to 2007. All underwent arthroscopy, provided mechanical instability was excluded (EUA and stress X-rays), and there were no signs of soft tissue impingement. These patients had exhausted all options of conservative therapy.

RESULTS

Seventy-seven patients with a mean age of 38.1: five had true mechanical instability and were excluded. 72 underwent arthroscopy: 67 (93.1%) had significant amounts of scar tissue needing debridement, most commonly in the antero-lateral corner (58.3%). 52 patients improved (72.2%) at a minimum of 6 months follow-up.

CONCLUSION

Our study supports the role of ankle arthroscopy in the treatment of FI following trauma. It should be considered when conservative measures have failed.

摘要

背景

踝关节扭伤很常见,大多数通过功能康复即可痊愈。但有些患者会遗留功能不稳定(FI)的症状。对于 FI 患者,踝关节镜检查在文献中报道较少。我们旨在评估其在踝关节 FI 中的作用。

方法

对 2005 年至 2007 年因踝关节扭伤后出现 FI 的患者进行回顾性病历分析。所有患者均接受了关节镜检查,排除了机械性不稳定(EUA 和应力 X 线),且无软组织撞击的迹象。这些患者已接受了所有保守治疗方法。

结果

77 例患者的平均年龄为 38.1 岁:其中 5 例存在真正的机械性不稳定,被排除在外。72 例行关节镜检查:67 例(93.1%)有大量需要清创的瘢痕组织,最常见于前外侧角(58.3%)。52 例患者在至少 6 个月的随访中得到改善(72.2%)。

结论

我们的研究支持创伤后 FI 行踝关节镜检查的作用。当保守治疗失败时,应考虑进行关节镜检查。

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