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在开放性踝关节骨折固定术前通过关节镜检查识别关节内病变。

Identifying Intra-Articular Pathology With Arthroscopy Prior to Open Ankle Fracture Fixation.

作者信息

Howard Shain, Hoang Victor, Sagers Kevin, Brady Candice, Eudy Adam, Watson Troy S

机构信息

Department of Orthopedic Surgery, Valley Hospital Medical Center, Las Vegas, Nevada, U.S.A.

Desert Orthopedic and Center, Las Vegas, Nevada, U.S.A.

出版信息

Arthrosc Sports Med Rehabil. 2021 Feb 4;3(1):e177-e181. doi: 10.1016/j.asmr.2020.08.020. eCollection 2021 Feb.

Abstract

PURPOSE

To assess the prevalence of intra-articular findings with ankle arthroscopy in patients undergoing operative fixation for ankle fractures.

METHODS

This is a retrospective review of ankle fractures that were treated with arthroscopy and open reduction and internal fixation by a single surgeon. Between August 2016 and July 2018, operative reports, office notes, and images were reviewed to identify intra-articular pathology and fracture type. An analysis was performed with regard to fracture type, presence and location of osteochondral lesions, loose-bodies, syndesmotic injury, and deltoid injury.

RESULTS

Fifty-seven ankle fractures were identified that met inclusion criteria. In total, 84.2% of the fractures had intra-articular pathology, most commonly a syndesmotic injury followed by presence of intra-articular loose bodies and osteochondral defects.

CONCLUSIONS

In our study, use of arthroscopy before open ankle fracture fixation identified intra-articular pathology in 84.2% of subjects. The most common pathology was syndesmotic injury. The addition of an arthroscopic assessment in patients with operatively treated ankle fractures may help improve treatment provided to patients during ankle fracture surgery.

LEVEL OF EVIDENCE

Level 4 Therapeutic Case Series.

摘要

目的

评估接受踝关节骨折切开复位内固定手术的患者,踝关节镜检查发现的关节内病变的患病率。

方法

这是一项对由单一外科医生进行关节镜检查及切开复位内固定治疗的踝关节骨折的回顾性研究。2016年8月至2018年7月期间,对手术报告、门诊记录和影像进行回顾,以确定关节内病变和骨折类型。对骨折类型、骨软骨损伤的存在及位置、游离体、下胫腓联合损伤和三角韧带损伤进行分析。

结果

确定了57例符合纳入标准的踝关节骨折。总体而言,84.2%的骨折有关节内病变,最常见的是下胫腓联合损伤,其次是关节内游离体和骨软骨缺损。

结论

在我们的研究中,踝关节骨折切开复位固定术前使用关节镜检查发现84.2% 的受试者有关节内病变。最常见的病变是下胫腓联合损伤。对接受手术治疗的踝关节骨折患者增加关节镜评估,可能有助于改善踝关节骨折手术期间为患者提供的治疗。

证据级别

4级治疗性病例系列。

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本文引用的文献

8
Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures.简要分类:踝关节骨折的劳格 - 汉森分类法。
Clin Orthop Relat Res. 2015 Oct;473(10):3323-8. doi: 10.1007/s11999-015-4306-x. Epub 2015 Apr 22.
10
Incidence of syndesmotic injury.下胫腓联合损伤的发生率。
Orthopedics. 2014 Mar;37(3):e226-9. doi: 10.3928/01477447-20140225-53.

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