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针式关节镜辅助修复胫腓联合急性损伤:一例报告。

Needle arthroscopic-assisted repair of tibio-fibular syndesmosis acute injury: A case report.

作者信息

Wojtowicz Blazej G, Domzalski Marcin, Lesman Jedrzej

机构信息

Department of Orthopedy and Trauma, Medical University of Lodz, Lodz 90-549, Lodz, Poland.

出版信息

World J Orthop. 2024 Aug 18;15(8):820-827. doi: 10.5312/wjo.v15.i8.820.

Abstract

BACKGROUND

Acute injuries to the tibiofibular syndesmosis, often associated with high ankle sprains or malleolar fractures, require precise diagnosis and treatment to prevent long-term complications. This case report explores the use of needle arthroscopy as a minimally invasive technique for the repair of tibiofibular syndesmosis injuries.

CASE SUMMARY

We report on a 40-year-old male patient who presented with a trimalleolar fracture and ankle subluxation following a high ankle sprain. Due to significant swelling and poor soft tissue quality, initial management involved external stabilization. Subsequently, needle arthroscopy was employed to assess and treat the tibiofibular syndesmosis injury. The procedure, performed under spinal anesthesia and fluoroscopic control, included nanoscopic evaluation of the ankle joint and reduction of the syndesmosis using a suture button. Follow-up assessments showed significant improvement in pain levels, range of motion, and functional scores. At 26 weeks post-procedure, the patient achieved full range of motion and pain-free status. Needle arthroscopy offers a promising alternative for the management of acute tibiofibular syndesmosis injuries, combining diagnostic and therapeutic capabilities with minimal invasiveness.

CONCLUSION

This technique may enhance clinical outcomes and reduce recovery times, warranting further investigation and integration into clinical practice.

摘要

背景

胫腓下联合急性损伤常与高位踝关节扭伤或踝关节骨折相关,需要精确诊断和治疗以预防长期并发症。本病例报告探讨了使用针式关节镜作为修复胫腓下联合损伤的微创技术。

病例摘要

我们报告了一名40岁男性患者,他在高位踝关节扭伤后出现三踝骨折和踝关节半脱位。由于肿胀严重且软组织质量差,初始治疗采用外固定。随后,使用针式关节镜评估和治疗胫腓下联合损伤。该手术在脊髓麻醉和荧光镜控制下进行,包括对踝关节进行关节镜评估以及使用缝线纽扣复位胫腓下联合。随访评估显示疼痛程度、活动范围和功能评分有显著改善。术后26周,患者达到了全活动范围且无痛状态。针式关节镜为急性胫腓下联合损伤的治疗提供了一种有前景的替代方法,它将诊断和治疗能力与最小的侵入性相结合。

结论

该技术可能改善临床结果并缩短恢复时间,值得进一步研究并纳入临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4568/11331323/0d69f67f5a4f/WJO-15-820-g001.jpg

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