踝关节镜下切除疼痛性距后三角骨临床疗效分析

目的:探讨经后方入路踝关节镜下切除疼痛性距后三角骨的临床疗效及安全性。方法:2002年1月～2007年10月,我所采用踝关节后内侧与后外侧入路、在关节镜下切除疼痛性距后三角骨22例。22例患者均表现为踝关节后侧疼痛,主动及被动跖屈时疼痛加重。术后21例患者获得随访,平均年龄为23.7岁(13～47岁),平均随访时间为33个月(8～75个月)。根据主观和客观评分判断疗效。结果:术后患足的美国足踝外科(AOFOS)踝关节与后足评分(94.8±5.1分)显著高于术前(73.3±3.6分)(t=19.66,P<0.001);术后主观疼痛程度评分(0.62±0.59分)显著低于术前(4.90±0.77分)(t=25.06,P<0.001);疗效优良率为95.2%。结论:经后方入路踝关节镜下切除疼痛性距后三角骨临床效果良好,手术安全。

Clinical Outcome of Arthroscopic Excision of Os Trigonum

Objective To evaluate therapeutic effect and safety of posterior ankle arthroscopic excision of symptomatic os trigonum. Methods Clinical records of 22 patients with symptomatic os trigonum were reviewed.Posterior ankle arthroscopic excision of the process was performed for all patients.21 of the patients were followed up for an average of 33 months.A visual analog scale(VAS) for pain,and the ankle and hindfoot scoring system of American Orthopaedic Foot and Ankle Society(AOFAS) were obtained before and after the excision. Results The average ankle-hindfoot score of AOFAS was 94.8±5.1 after operation,while it was 70.9±7.6 before operation(t=19.66,P<0.001).The score of VAS after operation(0.62±0.59) was significantly lower than that before operation(4.90±0.77)(t=25.06,P<0.001).Of the 21 patients,good to excellent results revealed in 20. Conclusions Posterior ankle arthroscopic excision of symptomatic os trigonum is effective and safe.