踝关节镜治疗踝前撞击综合征的临床疗效丁浩;谢水华;王小鹏;陈卫东;何建华;吴军;夏明华;胡前芹【期刊名称】《江西医药》【年(卷),期】2015(000)007【摘要】Objective To study the therapeutic effect of combination of rehabilitation treatment with atthroscopic treatment of anterolateral ankle impingement syndrome. Methods From March 2011 to August 2014,42 cases of anterolateral ankle impinge-ment syndrome were randomly divided into three groups:the treatment group and the control group,14 cases in each group. Re-sults All the cases were followed. The follow-up was 4 to 45 months. According to Ogilvie Harris scoringsystem ,preoperative and postoperative assessment was conducted,and the preoperative condition points more similar between the three groups has no statis-tical significance (P>0.05). The treatment group:thepostop erative condition (15.35 ±0.74) points,compared with the preoperative condition (6.85±1.46)points,was significantly increased,which had statistical significance (t=17.57,P<0.05). good rate was 100%. The control A group:the postoperative condition(14.36±1.21) points,compared with the preoperative condition(6.88±1.42) points, was significantly increased,which had statistical significance (t=18.36,P<0.05). Among the 14 cases,13 patients reported that an-kle pain and swelling disappeared and the functions recovered to the normal.1 patients presented with mildlimitation in ankle dor-siflexion activity,swelling and pain after the activity. good rate was 85.71%. The control B group:the postoperative condition(13. 93±1.59) points,compared with the preoperative condition (6.92±1.38) points,was significantly increased,which had statistical sig-nificance(t=18.72,P<0.05). Among the 14 cases,12 patients reported that ankle pain and swelling disappeared and the functions recovered to the normal. 2 patients presented with mild limitation in ankle dorsiflexionactivity ,swelling and pain after the activity. good rate was 85.71%. Good rate and postoperative 12 weeks of the treatment group condition points significantly higher than the control group A and group B. The postoperative condition points more similar between the three groups has no statistical signifi-cance(P>0.05). Conclusion The arthroscopic treatment of anterolateral ankle impingement syndrome is safe,effective and less in-vasive. After chinese medicine fumigation combined with articular cavity injection of sodium hyaluronate of rehabilitation treatment is a quick recovery,less pain and Good functional recovery.%目的：探讨踝关节镜结合术后康复治疗踝前撞击综合征的临床疗效。
关节镜下治疗踝关节撞击征的临床效果观察摘要目的针对关节镜下治疗踝关节撞击征的临床效果进行观察与分析。
方法28例踝关节撞击征患者，按照治疗方法的不同分为试验组和对照组，各14例。
试验组患者采取关节镜下治疗；对照组患者采取传统切开的手术方法治疗。
观察两组患者经治疗后的临床效果并进行比较。
结果试验组的总优良率（92.86%）高于对照组的总优良率（57.14%）；对照组不良反应发生率（57.14%）明显高于试验组不良反应发生率（14.29%），差异均有统计学意义（P＜0.05）。
结论利用关节镜下治疗踝关节撞击征的临床效果好，准确性高，安全性强，创伤小，疾病恢复速度快，值得在临床上广泛推广和使用。
关键词关节镜下治疗；踝关节撞击征；临床效果踝关节撞击征是一种常见的踝关节疾病，在人们行走过程中承重着5倍的身体负荷，因此较易出现关节损伤的状况[1，2]。
关节镜为治疗以及观察患者关节内部疾病的观察镜，能够简单明了地观察关节内的情况，并且根据内部情况制订合理的治疗方法。
为了进一步提高踝关节撞击征的治愈率，选择本院28例踝关节撞击征患者的临床资料进行观察和分析。
现报告如下。
1 资料与方法1. 1 一般资料选取2011年11月～2014年11月本院治疗踝关节撞击征的患者28例，按照治疗方法的不同分为试验组和对照组，各14例。
试验组男8例，女6例，年龄17～52岁，平均年龄（34±7）岁；对照组男5例，女9例，年龄17～51岁，平均年龄（34±6）岁。
两组患者均符合踝关节撞击征的临床诊断标准。
原因分别为意外扭伤、车祸撞伤、慢性劳损、以及其他。
两组患者年龄、性别、病因、病情等一般资料比较差异无统计学意义（P>0.05），具有可比性。
1. 2 方法首先为两组患者均进行完善术前检查，确定诊断。
进而给予试验组患者关节镜下治疗，治疗前行硬膜外麻醉，患者采取仰卧位，通过对患处关节注射定量生理盐水使患处关节扩张，沿着扩张的关节使关节镜（30°广角，4.0 mm直径）进入关节内，对患者关节处各个部位进行详细的探查，确认是否存有滑膜充血、肿胀、增生，胫骨、距骨骨赘形成等情况，通过镜下观察结果给予适当的手术治疗；对照组患者行传统切开手术治疗。
关节镜手术治疗踝关节前方撞击综合征的疗效观察段圆慧;田孟强;孙云波;张东亮;田峥巍;孙和军;王琦【摘要】目的探讨关节镜手术治疗踝关节前方撞击综合征的临床疗效.方法回顾性分析我院2011年7月～ 2015年9月28例关节镜手术治疗踝关节前方撞击综合征的临床资料,男19例,女9例.年龄18 ～ 49岁,平均31岁.软组织撞击18例,骨性撞击10例.采用美国足踝外科(AOFAS)踝-后足评分标准和Meislin疗效评估标准评定疗效.结果 28例术后均获得随访,随访时间9 ～ 28个月,平均18个月.术前AOFAS踝-后足评分38 ～ 65分,(49.2±6.9)分,末次随访为72～95分,(88.5±5.5)分,明显提高(扛-26.000,P=0.000).采用Meislin疗效评估,优20例,良5例,可2例,差1例,优良率89.3％ (25/28).均未出现神经损伤及切口感染.结论关节镜是治疗踝关节前方撞击综合征的有效措施,操作简便,疗效可靠,术后功能恢复快,满意率高,值得在临床推广.%Objective To investigate the clinical effect of arthroscopic surgery in the treatment of anterior impingement syndrome of the ankle.Methods The study reviewed 28 patients with anterior impingement syndrome of ankle who were treated arthroscopically in our hospital from July 2011 to September 2015.There were 19 males and 9 females.The average age of patients was 31 years old (rang,18-49 years old).There were 18 cases of soft tissue impingement and 10 cases of bony impingement.The effect of surgery was assessed by hind foot-ankle scoring of American Othopedic Foot and Ankle Society (AOFAS) and the Meislin criteria.Results All the 28 patients were followed up for 9-28 months,with an average of 18 months.The AOFAS scores were 38-65 points (mean,49.2 ± 6.9 points) preoperatively and 72-95 points(mean,88.5 ± 5.5 points) at the latest follow-up,which were significantly improved (t =-26.000,P =0.000).Based on the Meislin criteria,the results were excellent in 20 cases,good in 5 cases,fair in 2 cases and poor in 1 case,the excellent and good rate being 89.3％ (25/28).There was no nerve injury and incision infection.Conclusions Arthroscopy is an effective measure for the treatment of anterior impingement syndrome of ankle.It is easy to perform,with reliable outcomes,fast recovery and high satisfaction rate,being worthy to be popularized in clinical practice.【期刊名称】《中国微创外科杂志》【年(卷),期】2017(017)006【总页数】4页(P534-537)【关键词】踝关节前方撞击综合征;软组织撞击综合征;骨性撞击综合征;关节镜【作者】段圆慧;田孟强;孙云波;张东亮;田峥巍;孙和军;王琦【作者单位】天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121;天津市人民医院关节与运动医学科,天津300121【正文语种】中文踝关节撞击综合征是由骨性或软组织的直接机械撞击而引起踝关节的关节疼痛和(或)关节活动受限的临床综合征，以前外侧撞击最多见，多数伴有或并发踝关节炎性改变，主要表现为踝关节慢性疼痛，肿胀，功能障碍，过度活动时疼痛加剧，为运动损伤所致，严重者可影响踝关节背伸和跖屈功能[1]。
