摘要
目的:比较短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳(CAI)的临床疗效。方法:回顾分析了2015年6月至2017年12月在本科就诊住院的CAI患者35例,男性20例,女性15例;平均年龄为26.1岁(16~47岁).其中17例行短缩缝合止点重建术治疗,18例行同种异体半腱肌重建受损踝关节外侧副韧带。两组术中均使用踝关节镜探查处理距骨骨软骨损伤。分别于术前、术后6周、术后3个月、术后6个月对患者进行美国足与踝关节协会踝与后足功能评分及Tegner运动水平评分,踝关节内翻应力位X线片测量距骨倾斜角并记录。记录患足术后疼痛、肿胀、再次扭伤情况,内翻应力试验及前抽屉试验检查。结果:所有患者均得到随访,无脱落病例。所有切口均一期愈合,无切口液化感染等并发症。术后踝关节前抽屉试验均转为阴性。两组患者术后AOFAS评分及Tegner评分、距骨倾斜角变化均较术前明显改善,两组间差异无统计学意义(P>0.05).结论:短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳均能够获得良好的临床疗效。
Objective：To discuss the clinical efficacy of shortening suture reconstruction and allogeneic tendon transplantation for chronic ankle instability.Methods：A retrospective analysis of 35 cases of CAI patients in my department from June2015 to December 2017 was reviewed.There were 20 males and 15 females with a mean age of 26.1 years（range from 16 to 47 years）.Seventeen of them were treated with shortening suture reconstruction,and eighteen patients underwent anatomical reconstruction of LCAL with a semitendinosus autograft.In both groups,ankle arthroscopy was used for the treatment of osteochondral injury of the talus.The AOFAS scores and Tegner scores were assessed in the patients respectively in the preoperative and postoperative 6 weeks,3 months after operation,postoperative 6 months,and the varus stress radiographs was taken to record the talar tilt angle.Postoperative pain,swelling and resprain were recorded,and varus stress test and anterior drawer test were performed.Results：All patients were followed up without shedding cases.All the incisions were healed in the first stage,and there were no complications such as incisional liquefaction infection.After surgery,the test of the anterior drawer of the ankle was negative.Postoperative AOFAS score and Tegner score of the two groupswere significantly improved compared with that before surgery,and there was no statistically significant difference between the two groups（P〈0.05）.Conclusion：Both shortening suture reconstruction and allogeneic tendon transplantation for chronic ankle instability can achieve good clinical efficacy.
作者
杨宗宇
刘非
崔亮
齐少霞
李森田
李莹丽
张国瑜
孙佩宇
YANG Zongyu;LIUFei;CUI Liang;QI Shaoxia;LI Sentian;LI Yinli;ZHANGGuoyu;SUN Peiyu(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061001,Hebei China;People Hospital of Mengcun Hui Autonomous County,Cangzhou 06]400,Hebei China;Department of Orthopedic,Beijing Traditional Chinese Medicine Hospital,Beijing 100010,China)
出处
《中国中医骨伤科杂志》
CAS
2018年第9期28-31,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
沧州市科技局支撑计划项目(2017277)
关键词
短缩缝合止点重建术
同种异体肌腱移植术
踝关节镜
慢性踝关节不稳
shortening suture reconstruction
allogeneic tendontransplantation
ankle arthroscopy
chronic ankle instability
