关节镜联合关节牵张成形术治疗踝关节创伤性关节炎

目的对比分析单纯关节镜手术与关节镜手术联合Ilizarov外固定架关节牵张术治疗踝关节创伤性关节炎的临床疗效。 方法纳入2016年10月至2018年4月聊城市中医医院收治的早中期踝关节创伤性关节炎患者30例，排除非创伤性关节炎和终末期踝关节炎。其中接受单纯踝关节镜手术者纳入对照组(n＝15)，接受关节镜手术联合Ilizarov外固定架关节牵张成形术者纳入研究组(n＝15)，术后随访6个月，对比分析两组患者的治疗效果：疼痛视觉模拟评分(VAS)、踝关节功能评分(Kofoed评分)以及生活质量的变化。计数资料比较采用卡方或Fisher精确检验，计量资料比较采用独立样本t检验。 结果研究组治疗有效率大于对照组(χ²＝7.214，P<0.05)，术后疼痛视觉模拟评分明显低于对照组(t ＝10.342，P<0.05)，Kofoed评分高于对照组(t ＝10.452，P<0.05)；研究组生活质量显著高于对照组(P<0.05)。 结论关节镜手术联合关节牵张成形术对早中期踝关节创伤性关节炎较单纯关节镜手术短期效果更好，可成为临床治疗中的一种选择，但远期效果尚需进一步研究。

Arthroscopy combined with distraction arthroplasty to treat post-traumatic arthritis of ankle joint

Objective To compare and analyze the clinical effect of arthroscopic surgery alone and arthroscopic surgery combined with distractionarthroplasty using Ilizarov external fixatorin the treatment of posttraumatic arthritis( PTA) of ankle joint. Methods From October 2016 to April 2018,30 patients with early and medium stage of traumatic arthritis of ankle were analyzed retrospectively. Non-traumatic arthritis of ankle and end-stage PTA were excluded. Among them,those who underwent ankle arthroscopic surgery alone were classified into the control group( n = 15), those who underwent arthroscopic surgery and distractionarthroplasty with Ilizarov external fixator joint were classified into the study group( n = 15). The follow-up time were six months. The therapeutic effect,pain visual analogue scale( VAS),ankle joint function score( Kofoed score),and the change of quality of life were analyzed contrastively. Chi-square test or Fisher test was used for counting data and independent t-test was used for measurement data. Results The effective rate of treatment in the study group was higher than that in the control group(χ^2= 7. 214,P <0. 05),the VAS score of postoperative pain was significantly lower than that in the control group( t =10. 342,P < 0. 05),the ankle joint function score( Kofoed score) was higher than that in the control group( t = 10. 452,P < 0. 05),and the quality of life in the study group was significantly higher than that in the control group( P < 0. 05). Conclusion In the treatment of early and mid-stage post-traumatic arthritis of ankle,the effect ofarthroscopic surgery combined with distractionarthroplasty is better than that of arthroscopic surgery alone,which can be a choice in clinical treatment,but the long-term effect needs further study.