关节镜治疗踝关骨折脱位术后踝前撞击综合征疗效分析.pdfVIP

目 录 中文摘要 ···················································1 英文摘要 ···················································3 引 言 ··················································5 正 文 ··················································7 1 研究对象和方法 ··········································7 2 结 果 ················································10 3 讨 论 ················································11 4 结 论 ··················································12 参考文献 ··················································13 附录 ······················································16 综 述 ··················································18 致 谢 ··················································2 8 攻读学位期间发表的学术论文目录 ·······················29 作者声明 ··················································3 0 个人简历 ··················································3 1 1 中 文 摘 要 目的：通过回顾性研究探讨关节镜下治疗踝关节骨折脱位术后踝前撞击 综合征的方法及疗效。 方法: 选择2009年8月后收治疗的20例踝关节骨折脱位术后发生踝前撞 击综合征的患者,在行内因定拆除时先行关节镜下处理作为治疗组（A 组）；选择 2007年9月-2009年8月，在开展踝关节镜前收治的20例踝关节 骨折脱位术后发生踝前撞击综合征的患者作为对照组（B组) ，只行切开 内固定取出，未做踝前撞击的处理。观察两组术后踝关节疼痛、活动后 肿胀、背伸度情况，并根据美国矫形足踝协会（AO FAS ）踝与后足评分 标准评分，对术后疗效进行分析对比。A组男14例，女6例；年龄18 ～42 岁， 平均28岁。左踝8例，右踝12 例。内固定术后至本次入院时间为12 ～16 个 月，平均13.8 个月。术前AO FAS评分，总分为（53.32 ± 9.24 ）分，疼痛 评分为（22.26 ± 1.22 ）分, 功能评分（25.35 ±9.25 ）。B组，通过查阅病 历电话及门诊随访收集资料。该组男13例，女7例；年龄18 ～45 岁，平 均27岁。左踝8例，右踝12例。内固定术后至二次入院时间为12 ～16 个 月，平均14 个月。术前AO FAS评分，总分为（54.68 ± 8.56 ）分，疼痛 评分为（24.36 ±4.22 ）分，功能评分（24.52 ± 8.68 ）两组术前各项对比 无差异。术后随诊，记录踝关节疼痛、活动后肿胀、背伸度情况，并根 据美国矫形足踝协会（AO FAS ）踝与后足评分标准评分，对术后疗效进 2 行分析对比。统计学分析方法计数资料采用X 检验，计量资料采用t检验， 临床等级资料采用Ridit检验，运算用SPSS13.0统计软件完成，检验标准 以P0.05有统计学意义。 结果： 所有患者均获随访，随访时间6 ～24个月，平均14