背景:后踝关节疼痛的常见原因之一是后踝关节撞击综合征(PAIS)。许多关于PAIS的研究都是针对运动员等特殊群体进行的,舞者,和足球运动员,而以前没有对非运动人群的研究。本研究旨在评估非运动人群中这种综合征的原因和治疗方法,并将其与运动人群进行比较。
方法:进行了回顾性分析,46例患者中有28例(60.9%)从两阶段保守治疗中恢复。46例患者中有18例(39.1%)在三个月内没有从保守治疗中获益,应用后足内窥镜检查。患者数据,包括性,年龄,职业,和体育活动水平,被记录下来。视觉模拟刻度(VAS),美国骨科足踝协会(AOFAS)后足评分,记录和Tegner评分。用4分Likert量表评估患者满意度。记录所有并发症。
结果:平均随访时间为27.4个月。在最后的后续检查中,AOFAS后足评分从66.4显著提高至96.8(p<0.001).Tegner活性评分从4.6显著提高到8.8(p<0.001)。VAS评分为6.4,增加至0.9(p<0.001)。使用4点李克特量表测量患者满意度,13(72.2%)表示手术程序非常好,4人(27.8%)表示良好。返回工作岗位的平均时间为4.2周。作为并发症,仅2例患者(11.1%)出现腓肠神经感觉障碍。
结论:这项研究可以认为是第一个在非运动人群中评估PAIS的研究。保守治疗显示出良好的效果,近三分之二的患者康复。应用于对保守治疗无反应的病例的后足内窥镜检查是一种成功的治疗方法,并发症发生率低。
BACKGROUND: A common cause of posterior ankle pain is posterior ankle impingement syndrome (PAIS). Many studies about PAIS have been conducted on special groups such as athletes and dancers; there has been no previous study of a nonathletic population. This study aimed to evaluate the causes and treatment methods of PAIS in the nonathletic population and compare it with the athletic population.
METHODS: A retrospective review was performed and 28 of 46 patients (60.9%) recovered from two-staged conservative therapy. In the 18 patients (39.1%) who did not benefit from 3 months of conservative treatment, hindfoot endoscopy was applied. Patient data, including sex, age, occupation, and sports activity level, were recorded. Visual analog scale, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores were recorded. Patient satisfaction was assessed with a 4-point Likert scale. Complications were recorded.
RESULTS: Mean follow-up was 27.4 months. At final follow-up, the AOFAS hindfoot score had significantly improved from 66.4 to 96.8 (P < .001). The Tegner score improved significantly from 4.6 to 8.8 (P < .001). The visual analog scale score was 6.4 and increased to 0.9 (P < .001). Using the 4-point Likert scale for patient satisfaction, 13 (72.2%) stated that the surgical procedure was excellent and five (27.8%) good. Mean time to return to work was 4.2 weeks. Sural nerve dysesthesia was seen in two patients (11.1%).
CONCLUSIONS: This is the first study to evaluate PAIS in the nonathletic population. Conservative treatment showed good results as nearly two-thirds of the patients recovered. Hindfoot endoscopy in those not responding to conservative therapy is a successful treatment with low complication rates.