摘要
背景：Brostom-Gould术解剖修复踝关节外侧副韧带治疗慢性踝关节外侧不稳（chronic lateral ankle instability,CLAD的效果满意，但尚无单纯修复距腓前韧带的国内报道。目的：探讨带线锚钉结合改良Brost6m．Gould术，单纯修复距腓前韧带韧带治疗CLAI的手术疗效。方法：回顾性分析2012年9月至2014年3月收治的27例（27足）CLAI患者的相关资料，男15例，女12例；年龄19～37岁，平均（28．4±6．4）岁；症状持续时间6～36个月，平均（17．4±10．1）个月。所有患者均接受带线锚钉结合Brostom-Gould术单纯解剖修复距腓前韧带治疗CLAI。术后定期随访，记录相关并发症并比较术前与末次随访时患者的距骨倾斜角、美国骨科足踝外科协会（AOFAS）踝与后足评分、正常行走时疼痛的视觉模拟评分（VAS）以及Karlsson踝关节功能评分。结果：27例患者中26例获得随访，1例失访；平均随访时间16-43个月，平均（31．8±9．4）个月。所有患者手术切口均一期愈合；至末次随访时所有患者均未出现踝关节外侧韧带再次断裂或不稳复发。末次随访时26例患者的距骨倾斜角由术前平均12．38°±2.35°降低至3．25°±1．33°；AOFAS踝与后足评分由术前平均（50．04±13．48）分上升至（85．46±9．05）分；VAS评分由术前平均（5．93±1．12）分降低至（1．85±1．65）分；Karls-son评分由术前平均（51．77±12．58）分上升至（84．23±9．08）分；各组数据均有统计学差异（P〈0．05）。结论：带线锚钉结合Brostom-Gould术单纯解剖修复距腓前韧带是治疗CLAI安全、有效的方法。
Background： Brostom-Gould anatomical repair of the lateral ankle ligaments can achieve satisfactory treatment for the chronic lateral ankle instability （CLAI）, but the result of only repair of the anterior tibiofibular ligament has not been reported in China. Objective： To investigate the effect of modified Brostom-Gould procedure with the suture anchors to re- pair the anterior tibiofibular ligament. Methods： The clinical data of 27 patients （27 feet） with CLAI who were admitted to our hospital between September 2012 and March 2014 were retrospectively analyzed. There were 15 males and 12 females with a mean age of （28.4±6.4） years （range, 19 to 37 years）. The duration of symptoms ranged from 6 to 36 months with an average of （17.4±10.1） months. All patients were treated with suture anchors with Brostom-Gould operation with only re- pair of anterior talofibular ligament. Complications and the talar tilt angle, American Orthopedic Foot and Ankle Surgery So- ciety （AOFAS） ankle and foot score, normal walking pain visual simulation score （VAS） and Karlsson ankle function score were recorded during follow-up. Results： Eventually 26 patients were followed up, and the mean follow-up time was （31.8±9.4） months （range, 16-43 months）. All the patients were with good wound healing. No lateral ligament of the ankle was bro- ken or unstable again at the last follow-up. At the end of follow-up, talar tilt angle, AOFAS ankle and foot score, VAS score and Karlsson score were 3.25°±1.33°, 85.46±9.05, 1.85±1.65 and 84.23±9.08, respectively, which were significantly differ- ent from preoperative ones （ 12.38°±2.35°, 50.04±13.48, 5.93±1.12, 51.77±12.58, P〈0.05）. Conclusions： Modifed Brostom- Gould procedure with only anterior talofibular ligament repair can achieve good result in short to medium term follow-up.
出处
《中国骨与关节外科》
2016年第5期427-431,共5页
Chinese Journal of Bone and Joint Surgery
关键词
踝关节
外侧韧带
踝
治疗结果
Ankle Joint
Lateral Ligament, Ankle
Treatment Outcome
