目的:研究踝关节外侧扭伤后关节窦综合征的发生率,观察关节窦注射皮质类固醇激素的临床疗效。
方法:对2021年1月至2022年1月期间391例踝关节外侧扭伤患者和88例使用糖皮质激素(复方倍他米松1ml+盐酸利多卡因4ml)的患者进行回顾性分析。有22名男性和66名女性,年龄29至60岁,平均(41.00±7.52)岁,病程1~12个月,平均(5.6±4.2)个月。收集术前视觉模拟评分(VAS)和美国骨科足踝协会(AOFAS)评分,1个月,3个月,6个月,治疗后12个月。
结果:所有88例患者完成了12个月的随访。踝关节外侧扭伤后关节窦综合征的发生率为22.5%。治疗后一个月,VAS评分为1.20±0.89,AOFAS评分为88.70±7.04。治疗后三个月,VAS评分为1.60±1.35,AOFAS评分为85.20±10.95。治疗6个月后,VAS2.35±1.39,AOFAS80.30±9.75。治疗后12个月,VAS评分为2.80±1.51,AOFAS评分为79.1±9.94。随访4个时间点治疗前后差异均有统计学意义(P<0.05)。
结论:这项研究的结果表明,踝关节外侧扭伤后关节窦综合征的发生率为22.5%。皮质类固醇注射在短期内有效,1年内症状复发率为65%。对于长期效果不明显的保守治疗患者,临床医生可能会探索替代方法,包括踝关节镜等选项。
OBJECTIVE: To study the incidence rate of sinus tarsi syndrome after lateral ankle sprain and observe the clinical efficacy of sinus tarsal corticosteroid injections.
METHODS: From January 2021 to Janury 2022, 391 patients with lateral ankle sprain and 88 patients with sinus tarsi syndrome using corticosteroid injections (compound betamethasone 1 ml+ lidocaine hydrochloride 4 ml) were retrospectively analyzed. There were 22 males and 66 females, aged from 29 to 60 years old with an average of (41.00±7.52) years old, duration of the disease from 1 to 12 months with an average of (5.6±4.2) months. The visual analogue scale(VAS) and American Orthopedic Foot and Ankle Society(AOFAS) scores were collected before, 1 month, 3 months, 6 months, and 12 months after treatment.
RESULTS: All 88 patients completed a 12-month follow-up. The incidence rate of sinus tarsi syndrome after lateral ankle sprain was 22.5%. One month after treatment, VAS was 1.20±0.89, AOFAS score was 88.70±7.04. Three months after treatment, VAS was 1.60±1.35, AOFAS score was 85.20±10.95. Six months after treatment, VAS 2.35±1.39, AOFAS 80.30±9.75. Twelve months after treatment, VAS was 2.80±1.51, AOFAS score was 79.1±9.94. Significant differences were found before and after treatment at all four time points of follow-up(P<0.05).
CONCLUSIONS: The results of this study showed that the incidence rate of sinus tarsi syndrome after lateral ankle sprain was 22.5%. Corticosteroid injections were effective in the short term with a 65% recurrence rate of symptoms within 1 year. For patients with no significant long-term effect of conservative treatment, clinicians may explore alternative approaches, including options like ankle arthroscopy.