目的 探讨关节镜下清理辅助治疗旋后外旋型踝关节骨折的手术疗效。方法 回顾性选取2018年1月—2023年1月收治的52例旋后外旋型踝关节骨折患者作为研究对象,按照是否使用关节镜下清理分为试验组（28例）和对照组（24例）。试验组采用切开复位内固定术后行关节镜下清理踝关节,对照组采用切开复位内固定术。比较两组的手术时间,术中出血量、术后6个月步行时踝关节疼痛视觉模拟评分法（VAS）评分、术后6个月踝关节最大背伸活动度及踝关节的Baird-Jackson功能评分。结果 试验组患者的手术时间为（81.25±11.75） min,长于对照组的（72.08±11.31） min,差异有统计学意义（P<0.05）;试验组患者的术中出血量为（47.32±18.48） mL,多于对照组的（42.70±17.25） mL,但差异无统计学意义（P>0.05）;试验组的术后6个月步行时踝关节疼痛VAS评分（1.67±1.05）少于对照组（2.62±1.31）,差异有统计学意义（P<0.05）,试验组的踝关节最大背伸活动度[（18.71±4.78）°],大于对照组[（13.54±6.11）°],差异有统计学意义（P<0.05）;试验组患者的踝关节功能优于对照组,差异具有统计学意义（P<0.05）。结论 旋后外旋型踝关节骨折内固定术后使用关节镜下清理,可减少术后踝关节疼痛,增加踝关节背伸活动范围,改善踝关节术后功能,临床效果满意,值得推广。

Objective To investigate the surgical efficacy of arthroscopic debridement assisted treatment for supination-external rotation ankle fractures. Methods A total of 52 patients with supination-external rotation ankle fractures admitted to the Qingyuan Hospital Affiliated to Guangzhou Medical University from January 2018 to January 2023 were retrospectively divided into group A （28 cases） and group B （24 cases） according to whether arthroscopic cleaning was used during surgery. Group A underwent arthroscopic assisted ankle joint cleaning after open reduction and internal fixation surgery, while group B underwent traditional open reduction and internal fixation surgery. The operative time and intraoperative blood loss were compared between group A and group B. At the postoperative 6th month, visual analogue scale (VAS） scores of ankle pain during walking, maximum ankle dorsiflexion range of motion, and Baird-Jackson ankle score were compared between group A and group B. Results The operative time in group A was （81.25±11.75） min, significantly longer than that in group B, （72.08±11.31） min （P<0.05）. The intraoperative blood loss in group A was （47.32±18.48） mL, more than that in group B, （42.70±17.25） mL, and the difference was not statistically significant （P>0.05）. At the postoperative 6th month, the VAS score for ankle pain during walking in group A （1.67±1.05） was lower than that in group B （2.62±1.31）, while the maximum ankle dorsiflexion range of motion in group A [（18.71±4.78）°] was larger than that in group B [（13.54±6.11）°], with a statistically significant difference （P<0.05）. The ankle joint function of group A was better than that of group B, with a statistical difference （P<0.05）. Conclusion Arthroscopic debridement at the time of open reduction and internal fixation in supination-external rotation ankle fractures may reduce postoperative ankle pain, increase ankle dorsiflexion range of motion, and improve postoperative ankle function, which is worth being recommended.