Williams M M, Ferkel R D
Department of Orthopedic Surgery, The University of California at Los Angeles, USA.
Arthroscopy. 1998 May-Jun;14(4):373-81. doi: 10.1016/s0749-8063(98)70004-0.
The purpose of this study was to present the indications, technique, and results for subtalar arthroscopy in 50 consecutive patients. In each case, ankle arthroscopy was performed concomitantly to assess the exact source of the patient's pain. Surgical indications included chronic pain, swelling, buckling, and/or locking that failed conservative treatment. Arthroscopy of the ankle and subtalar joints were performed using both 2.7- and 1.9-mm arthroscopes through standard and accessory portals; distraction was used in all cases. All patients were followed-up for an average of 48 months (range, 36 to 70 months). Group 1 included 21 patients (42%) with chronic lateral ankle pain following an inversion injury. In this group, the subtalar joints were completely normal and the pathology was found to be limited only to the ankle joint. In group 2, 29 patients (58%) had the following diagnoses at arthroscopy: synovitis, 7; degenerative joint disease, 5; subtalar dysfunction, 5; chondromalacia, 4; nonunion of os trigonum, 4; arthrofibrosis, 2; loose bodies, 1; and osteochondral lesions of the talus, 1. Overall, the results were 86% good-to-excellent in group 2.
本研究的目的是介绍连续50例患者距下关节镜检查的适应症、技术及结果。每例患者均同时进行踝关节镜检查以评估疼痛的确切来源。手术适应症包括经保守治疗无效的慢性疼痛、肿胀、屈曲和/或交锁。使用2.7毫米和1.9毫米关节镜通过标准和辅助入路对踝关节和距下关节进行关节镜检查；所有病例均采用牵引。所有患者平均随访48个月（范围36至70个月）。第1组包括21例（42%）内翻损伤后出现慢性踝关节外侧疼痛的患者。在该组中，距下关节完全正常，病变仅局限于踝关节。第2组有29例（58%）患者在关节镜检查时有以下诊断结果：滑膜炎7例；退行性关节病5例；距下关节功能障碍5例；软骨软化4例；三角骨不愈合4例；关节纤维性变2例；游离体1例；距骨骨软骨损伤1例。总体而言，第2组的结果为86%优至良。
