研究后外侧注水通道在关节镜下踝关节融合术中应用的临床疗效，为技术推广提供参考。

随访2005年7月至2017年7月在西南医院关节外科实施关节镜下踝关节融合术的患者。为提高关节镜器械的工作效率2014年3月起建立后外侧注水通道。将2005年7月至2014年3月的病例分为对照组，2014年3月至2017年7月的病例分为观察组，比较两组手术时间，两组手术前后的美国足踝外科学会踝－后足(AOFAS)评分，两组骨性融合时间。手术时间、骨性融合时间及AOFAS评分等计量资料采用t检验或非参数秩和检验进行统计学分析。

所有患者获得随访，总共78例，其中观察组43例，对照组35例，随访时间(47±24)月(13～94月)。全部患者均在术后(15±3)周(11～20周)骨性融合，疼痛症状明显缓解，功能步态得到改善。早期对照组出现切口愈合不良1例，经换药后切口愈合良好。两组均未发现感染、深静脉血栓形成等并发症。在随访期间有5例患者踝关节融合术后出现距下关节炎。观察组手术时间(89±8)min与对照组(109±10)min比较，差异有统计学意义(t＝9.290，P<0.01)。观察组术后1年AOFAS评分与术前相比差异有统计学意义(t＝12.629，P<0.01)，对照组术后1年AOFAS评分与术前相比差异有统计学意义(t＝12.652，P<0.01)，但是两组间对应时间点比较差异无统计学意义(P>0.05)。两组的骨性融合时间差异无统计学意义(P>0.05)。

关节镜辅助下踝关节融合术中建立后外侧注水通道可以显著性缩短手术时间，提高手术效率，但是本技术存在学习曲线。

To evaluate the efficacy of posterolateral water inflow portal of arthroscopic ankle arthrodesis.

The patients who underwent arthroscopic ankle arthrodesis in Center for Joint Surgery, Southwest Hospital from July 2005 to July 2017 were followed up. The posterolateral water inflow portal was established from March 2014 to improve the efficiency of surgery. The patients from July 2005 to March 2014 were enrolled into the control groups and the patients from March 2014 to July 2017 were enrolled into the observation groups. The operation time, the AOFAS score and the bone fusion time were compared between the two groups by t test or rank sum test.

Seventy-eight cases were followed up, including 43 cases in the observation group and 35 cases in the control group. The average follow-up time was (47±24) months. All the patients achieved bone fusion at (15±3) weeks after surgery, pain relief and gait improvement. One patient in the control group had surgical wound bad healing which was cured by change dressing. There was no joint infection, deep venous thrombosis in either groups. Five patients were found subtalar arthritis over all follow-up periods. The operative time of the observation group was (89±8) min, which was significantly less than (109±10) min of the control group (t=9.290, P<0.01). The AOFAS scores were significant improvement after surgery in observation groups (t=12.629, P<0.01) and in control groups (t=12.652, P<0.01), there was no significant difference between the two groups (P>0.05). There was no significant difference in bone fusion time between the two groups (P>0.05).

The posterolateral water inflow portal can significantly shorten the operation time and improve the efficiency of arthroscopic ankle arthrodesis, but there is a learning curve about this technique.