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首页> 外文期刊>The Egyptian Journal of Hospital Medicine >Ankle Arthroscopy versus Conservative Modalities in Management of Ankle Impingement Syndrome: A Systematic Review of Literature
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Ankle Arthroscopy versus Conservative Modalities in Management of Ankle Impingement Syndrome: A Systematic Review of Literature

机译：踝关节镜检查与保守治疗踝关节撞击综合征：文献的系统评价

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Background: it has been well established that chronic ankle pain negatively affects the lives of patients. Surgical techniques for ankle pain have evolved dramatically over the past decade, as arthroscopic equipment has improved to allow excellent exposure to the ankle joint and surrounding anatomic areas. Soft- tissue and osseous impingement syndromes are now increasingly recognized as a significant cause of chronic ankle pain, The exact cause of this condition is debated but seems to involve osteophyte formation due to either repetitive microtrauma or macrotrauma associated with major injuries. Careful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. Aim of the work: this systematic review aimed to assess the outcome of ankle arthroscopy versus conservative modalities in management of ankle impingement syndrome. Methods: a systematic literature search of the PubMed, Embase (classic), and Chochrane library databases, for articles that published from January 1990 to June 2017 was performed using the following inclusion criteria English language puplications, human clinical trials, studies that reported on at least one of the chosen outcome measures which are patient satisfaction, time to return to full activity, AOFAS score, visual analog scale (VAS) score for pain, and complications, we found 9 studies met our inclusion criteria, data extraction was done which is consisted of population characteristics, in addition to the outcome measures. Results: nine articles were included in this systematic review. Overall, good results were found for arthroscopic treatment in patients with ankle impingement syndrome, patient satisfaction rates was reported in 5 studies, we reported high percentages of good to excellent satisfaction rates, ranging 74% to 94%, especially in patients treated with arthroscopy, Complication rates were 14.1%, as regard to patients treated with arthroscopy the rate was 13.2%, on the other hand the rate was 17.6% in those patients treated with injection therapy technique, conventional conservative modalities reported to be ineffective in treating ankle impingement except injection therapy technique in case of ankle soft tissue impingement. Conclusion: our systematic review showed that Patients may respond to conservative treatment modalities, especially ultra-sound guided injection mainly in soft tissue impingement type, arthroscopic debridement is the treatment of choice for patients of ankle impingement syndrome of both osseous and soft tissue nature with least morbidity and early return to function, and also it is noted to be superior to conservative modalities.
机译：背景：众所周知，慢性脚踝疼痛会对患者的生活产生负面影响。在过去的十年中，随着关节镜设备的改进，使踝关节和周围的解剖区域暴露在外，踝关节疼痛的手术技术得到了巨大的发展。如今，软组织和骨撞击综合征已被越来越多地认为是慢性踝关节疼痛的重要原因。这种情况的确切原因尚有争议，但由于与严重损伤相关的重复性微创伤或大创伤，似乎涉及骨赘的形成。在体格检查时仔细分析患者的病史，体征和症状可以建议对大多数患者进行具体诊断。工作的目的：这项系统的审查旨在评估踝关节镜检查的结果与治疗踝关节撞击综合征的保守方式。方法：使用以下纳入标准，对PubMed，Embase（经典）和Chochrane图书馆数据库进行系统文献检索，以1990年1月至2017年6月发表的文章进行英语​​语言重复，人体临床试验，所选择的结果指标中的至少一项是患者满意度，恢复完全活动的时间，AOFAS评分，疼痛的视觉模拟量表（VAS）评分和并发症的发生，我们发现9项研究符合我们的纳入标准，进行了数据提取除结局指标外，还包括人口特征。结果：这篇系统评价包括九篇文章。总体而言，踝关节撞击综合征患者的关节镜治疗效果良好，在5项研究中报告了患者满意率，我们报告的良好率至优秀满意度的百分比很高，范围在74％至94％之间，尤其是在接受关节镜检查的患者中，并发症率为14.1％，经关节镜检查的患者为13.2％，而经注射疗法治疗的患者为17.6％，传统的保守疗法据报道除注射外均不能有效治疗脚踝撞击脚踝软组织撞击时的治疗方法。结论：我们的系统评价表明，患者可能对保守治疗方式有反应，尤其是超声引导注射，主要针对软组织撞击类型，关节镜清创术是骨性和软组织性质的踝部撞击综合征患者的首选治疗方法发病率和早期恢复功能，也被认为优于保守疗法。

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