摘要
目的探讨下伸肌支持带移位加强联合关节囊紧缩术治疗不同残余程度距腓前韧带损伤导致慢性踝关节外侧不稳的临床疗效。方法选取2015-06至2019-08在武警特色医学中心骨科行下伸肌支持带移位加强联合关节囊紧缩术的58例慢性踝关节外侧不稳患者,年龄18~50岁,平均(25.3±8.6)岁,随访12~26(18.1±5.5)个月,所有患者术前均对距腓前韧带残留物损伤程度进行超声、磁共振评估,术中进一步明确评估结果,术后采用足踝功能评分(foot and ankle outcome score,FAOS)随访,评估术后踝关节功能,比较不同残余程度距腓前韧带损伤的修复疗效差异。结果58例中,术前超声检查48例可见距腓前韧带(auterjor tolofitular ligament,ATFL)残余,42例在MRI检查中可见ATFL残余,根据Cardone BW等按形态诊断ATFL损伤分级:19例韧带变薄,形态正常;10例韧带形态不规整;29例断端萎缩或缺失。58例采用下伸肌支持带移位加强联合关节囊紧缩术治疗,术中见ATFL残余17例,缺失41例。58例均获得随访,术后患肢功能恢复满意,术后FAOS各独立分量中结果差异无统计学意义。结论对于不同残余程度距腓前韧带损伤的慢性外踝关节不稳患者,中-短期临床随访结果表明,下伸肌支持带移位加强联合关节囊紧缩术临床疗效良好。
Objective To study the clinical efficacy of treating chronic lateral ankle instability caused by different residual degrees of anterjor talofibular ligament(ATFL)injury by using lower extensor retinaculum displacement and joint capsule tightening.Methods The clinical data on 58 patients with chronic lateral ankle instability treated in our hospital between June 2015 and August 2019 was analyzed.These patients were treated with lower extensor retinaculum displacement combined with joint capsule tightening.Their age ranged from 18 to 50,with an average of(25.3±8.6)years old.All the patients were followed up for 12 to 26(18.1±5.5)months.The foot and ankle outcome score(FAOS)was used to evaluate the function of ankle joints postoperatively,and the repair effect of different residual degrees of anterjor talofibular ligament injury was compared.Results Among the 58 patients screened in this study,48 showed residual ATFL by preoperative ultrasound.ATFL residues were seen in 42 patients on MRI.According to Cardone et al,ATFL injury grade was diagnosed morphologically:ligament thinning and normal morphology in 19 cases,irregular ligament morphology in 10 cases,and atrophy or loss of broken ends in 29 cases.ATEL residues were found in 17 cases and missing in 41 cases.All the patients were treated with extensor retinaculum displacement and joint capsule compression before follow-up.The functional recovery of the affected limbs was satisfactory.There was no significant difference in the independent components of postoperative FAOSs(P>0.05).Conclusions For patients with chronic lateral malleolus instability with different residual degrees of anterjor talofibular ligament injury,lower extensor retinaculum displacement combined with joint capsule tightening can achieve good clinical effect.
作者
刘爱鹏
贾鹏
王琪
赵冻
LIU Aipeng;JIA Peng;WANG Qi;ZHAO Dong(Department of Orthopedics,Characteristic Medical Center of Chinese People’s Armed Police Force,Tianjin 300162,China)
出处
《武警医学》
CAS
2021年第12期1017-1020,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
踝关节扭伤
距腓前韧带
下伸肌支持带
关节囊
慢性踝关节外侧不稳
ankle sprain
anterjor talofibular ligament
lower extensor retinaculum
joint capsule
chronic lateral ankle instability
