中国修复重建外科杂志

中国修复重建外科杂志

前距腓韧带修复术治疗踝关节外侧不稳定疗效分析

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目的 探讨前距腓韧带修复术治疗踝关节外侧不稳定的临床疗效及合并跗骨窦综合征对疗效的影响。 方法 回顾分析 2013 年 12 月—2014 年 10 月,采用前距腓韧带修复术治疗的 47 例踝关节外侧不稳定患者临床资料。其中,32 例未合并跗骨窦综合征(A 组);15 例合并跗骨窦综合征(B 组),同时行跗骨窦清理术。两组患者性别、年龄、病程、侧别以及术前美国矫形足踝协会(AOFAS)评分、Karlsson 评分、Tegner 运动功能评分等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。 结果 两组切口均Ⅰ期愈合,无早期手术相关并发症发生。患者均获随访,A 组随访时间 20~31 个月,平均 26.0 个月;B 组随访时间 20~31 个月,平均 24.7 个月。所有患者踝关节肿胀均消失,关节活动良好,恢复正常行走。末次随访时,两组 AOFAS 评分、Karlsson 评分、Tegner 运动功能评分均较术前明显提高,差异有统计学意义(P<0.05);组间比较差异无统计学意义(P>0.05)。随访期间无踝关节不稳复发。 结论 无论是否合并跗骨窦综合征,前距腓韧带修复术治疗踝关节外侧不稳定均能获得满意疗效。

Objective To evaluate the effectiveness of anterior talofibular ligament repair in the treatment of lateral ankle stability and the effect of combined tarsal sinus syndrome on results. Methods Between December 2013 and October 2014, 47 cases of lateral ankle instability underwent anatomical repair of anterior talofibular ligament, and the clinical data were retrospectively analyzed. Of 47 cases, 32 had no tarsal sinus syndrome (group A); 15 had tarsal sinus syndrome (group B), arthroscopic debridement of tarsal sinus was performed at the same time. There was no significant difference in gender, age, disease duration, side, American Orthopaedic Foot and Ankle Society (AOFAS), Karlsson score, and Tegner movement function score between 2 groups (P>0.05). Results No early surgical complication of infection occurred, and primary healing of incision was obtained in 2 groups. The patients were followed up 20-31 months (mean, 26.0 months) in group A, and 20-31 months (mean, 24.7 months) in group B. Disappearance of ankle swelling, good joints movement, and recovery of normal walking were observed in all patients. At last follow-up, AOFAS score, Karlsson score, and Tegner movement function score were significantly improved when compared with preoperative ones in 2 groups (P<0.05), but no significant difference was found between 2 groups (P>0.05). No ankle instability recurrence was found during follow-up period. Conclusion The effectiveness of anatomical repair of anterior talofibular ligament in lateral ankle instability is satisfactory for patients with or without tarsal sinus syndrome.

关键词: 踝关节不稳定; 韧带修复; 跗骨窦综合征

Key words: Ankle instability; ligament repair; tarsal sinus syndrome

引用本文: 陈守勃, 华英汇. 前距腓韧带修复术治疗踝关节外侧不稳定疗效分析. 中国修复重建外科杂志, 2017, 31(4): 427-431. doi: 10.7507/1002-1892.201611022 复制

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