踝关节镜临床应用体会

目的探讨踝关节镜在踝关节疾病的诊断和治疗中的应用。方法踝关节镜下检查和治疗15例，按以下顺序进行：（1）外侧沟，包括距腓韧带、腓距关节面、距骨外侧面；（2）距骨颈；（3）内侧沟与三角韧带；（4）后关节囊擘与后侧腔室。在关节镜直视观察下，经对侧入路进手术器械可施行滑膜活检、游离体取出、软骨损伤及软化病灶清理修整、撞击软组织和增生骨赘切除。结果诊断滑膜炎5例，骨性关节炎4例，痛风2例，足球踝1例，躁关节软组织撞击综合症3例。术后平均随访18个月，治疗效果优秀6例，良好9例。无感染及神经血管损伤并发症的发生。结论踝关节镜手术适应证广，可直接观察和处理踝关节的病变，明确诊断。踝关节镜手术具有损伤小，恢复快，并发症少的优点。

Clinical application of ankle arthroscopy

Objective To explore the application of arthroscopy in the diagnosis and treatment of ankle diseases. Methods 15 patients were examined and treated under arthroscopy. The procedure processed in the following order: ( 1 ) lateral sulcus including the talofibular ligament, talofibular articular surface, and the lateral aspect of the talus ( 2 ) talar neck; ( 3 ) medial groove and triangular ligament; ( 4 ) the rear wall and chamber. Under arthroscopy, synovial biopsy was performed, loose body was removedl, proliferative osteophyte was excised, and damaged or softened cartilage was repaired. Results 5 patients were diagnosed as synovitis,4 as osteoarthritis, 2 as gout, one as soccer ankle, and 3 as ankle soft tissue impingement syndrome. All the patients were followed up for an average of 18 months. The efficacy was excellent in 6 patients and satisfatory in 9.No infections and neurological or vascular injury were found. Conclusions Ankle arthroscopy had a wide surgical indication and can directly observe and treat ankle diseases and comfirm diagnosis. It has several advantages including smaller wounds, quicker recovery, and fewer complications.