ABSTRACT
Objective To discuss and summarize the effects of arthroscopic treatment of posterior ankle impingement syndrome.Methods The study enrolled 30 patients with posterior ankle impingement syndrome treated from January 2008 to November 2015.There were 18 males and 12 females,aged 19-58 years old (mean,37.6 years old).Right ankle injury was noted in 19 patients and left in 11 patients.A total of 27 patients had a history of obvious ankle injury (7 cases of acute sprains and 20 cases of chronic sprains).Arthroscopic surgery,including osteophyte removal,cartilage formation and joint clearance,was performed through the posterolateral and posteromedial approaches.Postoperative outcome was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores.Results All the patients were followed up for 8-27 months (mean,22 months).These patients got a good healing without nervous and vascular injuries.At the last follow up,the AOFAS score was (89.8 ± 3.8) points,significantly higher than before operation [(35.0 ± 10.1) points,t =-26.456,P =0.000].The VAS score was (2.5 ± 1.3) points,significantly lower than before operation [(6.6 ± 1.9) points,t =12.427,P =0.000].The ankle joint flexion angle was improved significantly from 29.4° ± 2.3° to 43.4° ± 1.4° as compared to preoperative status (t =-32.625,P =0.000).There were 21 cases of excellent result and 9 cases of good result,with an excellent and good rate of 100％.Conclusion Debridement and treatment of complications under arthroscopy is one of the effective methods for the posterior ankle impingement syndrome,which has advantages of minimal invasion,safety,targeted operation,and fast postoperative recovery.
ABSTRACT
Objective To compare the short-term effects of proximal humerus fractures by deltoid approach or delto-pectoral approach .Methods The clinical records of 53 patients with proximal humeral fracture for two kinds of different treatment were re-viewed :delto-pectoral approach with anatomical form plate(delto-pectoral group ,24 cases) or anterolateral deltoid approach with locking proximal humerus plate (anterolateral deltoid approach group ,29 cases) from May 2008 to May 2013 .The length of inci-sion ,bleeding volume ,postoperative painscores ,union of fracture time ,incidence of complications ,pain and function of shoulder score (Neer scores) were compared and recorded .Results All the patients were followed up for 6 - 24 months(mean 16 .3 month) , and all patients obtained bone union .The anterolateral deltoid approach was significantly higher than delto-pectoral approach in the operation fime ,the bleeding volume ,postoperative painscores ,union of fracture time ,pain and function of shoulder score(after a month)(P 0 .05) .By delto-pectoral approach ,there were 2 cases with delayed wound healing ,3 cases underwent the loosening of screw ,4 cases humerus head varus and 2 cases necrosis of head of humerus ,with the rate of complications of 45 .8% .On the other hand ,deltoid approach group were 2 cases underwent screw cutting and 2 cases humerus head varus ,with the rate of complications of 13 .8% (P< 0 .05) .Conclu-sion The clinical results of anterolateraldeltoid approach group with locking proximal humerus plate had the advantage of reliable fixation ,less suffering ,less surgical trauma and less complication ,which was better the short-term effects than delto-pectoral ap-proach with atomical from plate .