【摘要】 目的：对比踝关节镜下微骨折手术与常规开放手术治疗距骨骨软骨损伤（OLT）的疗效。方法：回顾性分析2017年5月～2021年5月期间首都医科大学附属北京地坛医院收治的90例OLT患者的临床资料。按照手术方式的不同将患者分为A组（常规开放手术，44例）和B组（踝关节镜下微骨折手术，46例）。对比两组临床指标、视觉模拟评分（VAS）、美国矫形外科足踝协会（AOFAS）评分、踝关节背伸-跖屈活动度、影像学评估结果和并发症发生率。结果：B组术中出血量少于A组，手术时间、下地行走时间、完全负重时间短于A组（P<0.05）。B组末次随访VAS评分低于A组，AOFAS评分高于A组，踝关节背伸-跖屈活动度大于A组（P<0.05）。两组末次随访改良Outerbridge分级、Kellgren-Lawrence分级比例均得到改善，且B组的改善效果优于A组（P<0.05）。B组的并发症发生率低于A组（P<0.05）。结论：与常规开放手术相比，踝关节镜下微骨折手术治疗OLT患者，在恢复踝关节功能、缓解疼痛及促进康复进程等方面疗效更好，同时还可降低并发症发生率。更多还原

【Abstract】 Objective: To compare the efficacy of ankle arthroscopic microfracture surgery and conventional open surgery in the treatment of osteochondral injury(OLT) of talus. Methods: The clinical data of 90 OLT patients who were admitted to Beijing Ditan Hospital Affiliated to Capital Medical University from May 2017 to May 2021 were retrospectively analyzed. Patients were divided into group A(conventional open surgery, 44 cases) and group B(ankle arthroscopic microfracture surgery, 46 cases) according to the different surgical methods. The clinical indicators, visual analogue scale(VAS), American Orthopaedic Foot and Ankle Society(AOFAS)score, ankle dorsiflexion-metatarsal flexion activity, imaging evaluation results and complication rate were compared between two groups. Results: The intraoperative blood loss in group B was less than that in group A, and the operation time, walking time and full weight-bearing time were shorter than those in group A(P<0.05). At the final follow-up, the VAS score in group B was lower than that in group A, the AOFAS score was higher than that in group A, and the ankle dorsiflexion-plantar flexion activity was greater than that in group A(P<0.05). The modified Outerbridge grading and Kellgren-Lawrence grading ratio in two groups were improved at the last follow-up, and the improvement effect in group B was better than that in group A(P<0.05). The incidence of complications in group B was lower than that in group A(P<0.05). Conclusion: Compare with conventional open surgery, ankle arthroscopic microfracture surgery for OLT patients has better efficacy in restoring ankle function, relieving pain and promoting the rehabilitation process, and can also reduce the incidence of complications.更多还原