25 KB129 KB23 KB192920262001Senekovič, VladimirŠaćiri, Valdetštevilka:10letnik:70str. 539-542ISSN:1318-0347COBISSID:14052057URN:URN:NBN:SI:doc-ORTLHGFGslSlovensko zdravniško društvoZdravniški vestnikAnkle jointArthroscopyArtroskopijaIzid zdravljenjaPostoperative complicationsPostoperativne komplikacijesklepiskočni sklepSkočni sklep zgornjiSurgeryTreatment outcomeArtroskopske operacije v zgornjem skočnem sklepu| Operativne arthroscopy of the ankle joint|Background. Arthroscopy of the ankle joint has become a standard diagnostic method. Some types of injuries of the ankle joint can be successfully treated with arthroscopic procedures. Methods. From 1993 to 2001 we have performed operative arthroscopy at 47 patients with different pathological conditions, including osteochondral fractures, osteochondritis dissecans, osteoarthritis secondary to ankle joint injury, loose bodies, anterior soft tissue impigement, septic arthritis and deformation after healing of talus fracture. The following arthroscopic procedures were carried out. synovectomy, removal of osteophytes, fragments, unstable cartilage, loose bodies cicatrices and dislocated bone in the front of the joint after healing of the talus fracture,drilling of the chondral defects and cleaning of the jointatpurulent arthritis. Results. The results were evaluated by Martin's scale. At the follow up results were excellent at 25 patients (53%), good at 17 (36%), fair at 3 (16%) and bad at 2 patients (4%). We had moderate complications at 4 patients (8.5%). At three transient hiposensibility of the dorsolateral part of the food was occurred because of injury of the branches of the superficial peroneal nerve. One patient has had synovial fistul for two months which has closed spontaneously. This is correlated with data in literature. Conclusions.In some cases we found out the real diagnosis at arthroscopy but we have never done only diagnostic arthroscopy. We mean according to our results that some injuries and diseases of the ankle joint have to be treated by arthroscopic surgical methods. We mean also according to over experiences that only diagnostical arthroscopy should not be done. Always operative arthroscopy has to be performedIzhodišča. Artroskopija zgornjega skočnega sklepa je postala standardni diagnostični postopek. Pri zdravljenju različnih poškodb ali bolezni v zgornjem skočnem sklepu pa se vse bolj uveljavljajo artroskopske operacije. Metode. Od leta 1993 do 2001 smo opravili 47 artroskopskih operativnih posegovpri različnih patoloških stanjih: pri artroyi sklepa, pri osteohondralnih zlomih, pri disekantnem osteohondritisu, pri prostih telesih vsklepu, pri ukleščenju mehkih tkiv v sprednjem delu sklepa, pri gnojnem vnetju sklepa in pri napačno zaraščenem zlomu. Naredili smo naslednje posege: sinovektomijo v sprednjem delu sklepa, odstranitev osteofitov, zarastlin, prostih teles, prostih odlomkov in napačno zaraščene kosti, abrazije nestabilnega hrustanca, navrtanje eksponiranih kosti pri defektu hrustanca, izpiranje pri vnetju ter zatrdetev sklepa. Rezultati. Merila za ocenjevanje rezultatov smo povzeli po Martinu. Pa končanem zdravljenju je bil rezultat odlečen pri 25 bolnikih (53 %), dober rezultat pri 17 (36%), zadovoljiv pri 3 (6%) in slab pri 2 bolnikih (4%). Lažje zaplete smo imeli pri 4 bolnikih (8,5%bolnikov), kar se ujema s podatki v literaturi. V treh premerih je šlo zaprehodno omrtvičenost dorzolateralnega dela stopala zaradi poškodbe vej povrhnjega peronealnega živca, v enem primeru pa za sinovijsko fistulo, ki se je po dveh mesecih spontano zaprla. Zaključki. V nekaterih naših primerih smo diagnozo postavili šele med artroskopijo, v vseh primerih pa smo opravili artroskopsko operacijo. Glede na naše rezultate menimo, da je potrebno nekatere poškodbe in bolezni zgornjega skočnega sklepa zdraviti z artroskopskooperacijo. Menimo pa, da samo eksplorativna artroskopija ne smiselna, vedno je potrebno opraviti tudi artroskopski operativni posegTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo