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[踝关节撞击症。适应证与关节镜治疗]

[Ankle impingement. Indications and arthroscopic therapy].

作者信息

Buchhorn T, Koch M, Weber J, Ziai P

机构信息

Sporthopaedicum Straubing-Berlin-Regensburg-München, Bahnhofsplatz 27, 94315, Straubing, Deutschland.

Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.

出版信息

Unfallchirurg. 2016 Feb;119(2):115-9. doi: 10.1007/s00113-015-0135-3.

Abstract

Ankle impingement syndromes are one of the most frequent chronic and posttraumatic pathologies of the ankle joint. Anterior and posterior impingement result from the abutting of anatomical structures leading to pain and limitation in the range of motion of the ankle joint. Ankle impingement can be classified based on the localization or the underlying cause. Besides chronic ankle pain, further symptoms are movement and load-dependent swelling of the ankle joint and limitations in dorsiflexion and plantar flexion. The clinical symptoms and physical examination play an essential role in diagnosing soft tissue impingement, whereas various imaging techniques are important for the diagnostics of bony impingement. From a therapeutic perspective, conservative treatment should be initially attempted. If non-operative treatment fails, arthroscopic resection and debridement of the underlying cause is nowadays the standard method of surgical treatment. With a current complication rate of approximately 3 % ankle arthroscopy is a safe operative method, which is associated with a high postoperative rate of patient satisfaction and significant relief of symptoms.

摘要

踝关节撞击综合征是踝关节最常见的慢性和创伤后病变之一。前侧和后侧撞击是由于解剖结构相互挤压,导致踝关节疼痛和活动范围受限。踝关节撞击可根据其发生部位或潜在病因进行分类。除慢性踝关节疼痛外,其他症状还包括踝关节的运动和负重依赖性肿胀,以及背屈和跖屈受限。临床症状和体格检查在诊断软组织撞击中起着至关重要的作用,而各种影像学技术对诊断骨撞击很重要。从治疗角度来看,应首先尝试保守治疗。如果非手术治疗失败,如今关节镜下切除并清除潜在病因是手术治疗的标准方法。目前踝关节镜手术的并发症发生率约为3%,是一种安全的手术方法,术后患者满意度高,症状明显缓解。

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