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踝关节镜手术

Arthroscopic surgery of the ankle.

作者信息

Barber F A, Britt B T, Ratliff H W, Sutker A N

机构信息

Division of Orthopedic Surgery, University of Texas Health Science Center, Dallas.

出版信息

Orthop Rev. 1988 May;17(5):446-51.

PMID:3050810
Abstract

Ankle arthroscopy is a useful technique, especially for intra-articular problems and osteocartilagenous lesions. Indications for this diagnostic and therapeutic technique include: ankle sprain unresponsive to the usual course of treatment, complaints of intermittent locking, pain and clicking, limitation of motion, and painful conditions with no obvious etiology (especially in a worker's compensation beneficiary). A review of arthroscopic, radiographic, and clinical data of all patients undergoing ankle arthroscopy at our center provided the following diagnoses: talar dome osteochondral fractures, loose bodies, accessory ossicles, talar dome cyst with loose bodies, and chronic synovitis. The anatomy of ankle arthroscopy is demanding; while the technique incorporates the same instrumentation as is used for knee arthroscopy, awareness of the neurovascular structures is essential to avoid complications. Although infrequent, complications can include sinus tract formation, sensory nerve damage, synovitis, infection, instrument breakage, and calf compartment syndromes due to extravasation of irrigation fluid.

摘要

踝关节镜检查是一项有用的技术,尤其适用于关节内问题和骨软骨损伤。这种诊断和治疗技术的适应证包括:对常规治疗无反应的踝关节扭伤、间歇性绞锁、疼痛及弹响的主诉、活动受限,以及病因不明的疼痛状况(尤其是在工伤赔偿受益者中)。对在我们中心接受踝关节镜检查的所有患者的关节镜、影像学和临床数据进行回顾后得出了以下诊断结果:距骨穹窿骨软骨骨折、游离体、副骨、伴有游离体的距骨穹窿囊肿以及慢性滑膜炎。踝关节镜检查的解剖结构要求较高;虽然该技术使用的器械与膝关节镜检查相同,但了解神经血管结构对于避免并发症至关重要。并发症虽然不常见,但可能包括窦道形成、感觉神经损伤、滑膜炎、感染、器械断裂以及因冲洗液外渗导致的小腿间隔综合征。

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