摘要
目的评估踝关节镜清理联合自体半腱肌重建距腓前韧带(ATFL)和跟腓韧带(CFL)治疗慢性踝关节外侧不稳的临床效果。方法选择2016年10月至2020年6月我科采用踝关节镜清理联合自体半腱肌重建ATFL和CFL治疗的16例慢性踝关节外侧不稳患者为研究对象。分析术后随访结果,包括切口愈合情况、临床症状改善情况、昂白试验结果、美国矫形外科足踝协会踝-后足评分(AOFAS)评分、距骨倾斜角、踝关节抽屉试验结果。结果患者均获得随访,随访时间12~18个月,中位时间15个月;切口均达一期甲级愈合;均未再发生踝关节扭伤,踝关节慢性疼痛症状完全消失,昂白试验阴性。末次随访时,患者的AOFAS评分、距骨倾斜角及踝关节抽屉试验均优于术前,差异具有统计学意义(P<0.05)。结论采用踝关节镜清理联合自体半腱肌重建ATFL和CFL可明显改善慢性踝关节外侧不稳,减轻踝关节肿胀、疼痛等症状,恢复踝关节的稳定性,改善踝关节活动能力,具有微创、操作简单、疗效可靠的优点,值得在临床推广应用。
Objective To evaluate the clinical effect of ankle arthroscopic debridement combined with autologous semitendinosus reconstruction of anterior talofibular ligament(ATFL)and calcaneofibular ligament(CFL)in the treatment of chronic lateral ankle instability.Methods From October 2016 to June 2020,16 patients with chronic lateral ankle instability treated with ankle arthroscopic debridement combined with autologous semitendinosus reconstruction of ATFL and CFL in our department were selected as the study objects.The postoperative follow-up results were analyzed,including incision healing status,improvement status of clinical symptoms,results of blanching test,American Orthopaedic Foot and Ankle Society(AOFAS)score,talar tilt angle and ankle drawer test results.Results All patients were followed up for 12 to 18 months,with a median time of 15 months;the incisions all reached primary grade A healing;no ankle sprain occurred again,the symptoms of chronic pain of the ankle disappeared completely,and the Romberg's test was negative.The AOFAS score,talus tilt angle and ankle drawer test of patients at the last follow-up were better than those before operation,and the differences were statistically significant(P<0.05).Conclusion Ankle arthroscopic debridement combined with autologous semitendinosus reconstruction of ATFL and CFL can significantly improve chronic lateral ankle instability,reduce ankle swelling,pain and other symptoms,restore ankle stability,and improve ankle mobility.It has the advantages of minimally invasive,simple operation and reliable curative effect,which is worthy of clinical promotion and application.
作者
牛永强
张德林
张树峰
NIU Yongqiang;ZHANG Delin;ZHANG Shufeng(No.3 Orthopedics Department,Traditional Chinese Medicine Hospital of Yulin,Yulin 719000,China)
出处
《临床医学研究与实践》
2023年第21期21-24,共4页
Clinical Research and Practice
基金
2019年度院内中青年科研基金项目(No.ZQ19YB07)。
关键词
慢性踝关节外侧不稳
踝关节镜清理
自体半腱肌重建
距腓前韧带
跟腓韧带
chronic lateral ankle instability
ankle arthroscopic debridement
autologous semitendinosus reconstruction
anterior talofibular ligament
calcaneofibular ligament
