摘要
目的:探讨踝关节镜辅助Brostrom-Gould手术治疗慢性踝关节外侧不稳(Chronic Lateral Ankle Instability,CLAI)的临床疗效。方法:回顾性分析2018年4月至2022年1月接受踝关节镜辅助Brostrom-Gould手术60例慢性踝关节外侧不稳患者的临床资料,男24例,女36例;平均年龄为(40.45±11.89)岁。术后定期随访,记录并比较术前与末次随访时患者美国足踝外科协会(AOFAS)量表评分、行走及不负重时视觉模拟量表(VAS)评分,对踝关节疼痛、功能、稳定性等指标进行评估。结果:60例患者获得随访,随访时间平均为(31.40±14.39)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韧带修复失效,查体前抽屉试验及内翻应力试验均为(-),磁共振影像显示距腓前韧带愈合。末次随访时AOFAS评分为(83.67±6.67)分,较术前(51.52±14.51)分明显上升,差异有统计学意义(P<0.001);行走VAS评分为(2.03±1.01)分,较术前(5.42±1.11)分显著降低,非负重VAS评分为(1.51±0.95)分,较术前(2.88±0.88)分也有降低,差异均有统计学意义(P<0.001);影像学评分为(1.48±0.81)分,与术前(1.23±0.70)分差异无统计学意义(P>0.05)。术区皮肤及皮下组织情况统计显示,18%的患者存在术后瘢痕,45%的患者存在皮下瘢痕硬结,仅有3例术区皮肤轻微感觉异常、5例手术切口轻微疼痛的报告。结论:踝关节镜辅助Brostrom-Gould术治疗慢性踝关节外侧不稳临床效果较为满意,且手术技术仍有优化空间。
Objective:To investigate the clinical efficacy of ankle arthroscopy assisted Brostrom-Gould operation in the management of chronic lateral ankle instability(CLAI).Methods:60 patients with CLAI who underwent ankle arthroscopy assisted Brostrom-Gould operation between April 2018 and January 2022 were retrospectively reviewed,24 males and 36 females with an average age of(40.45±11.89)years old.At regular follow-up after surgery,American orthopedic foot and ankle society(AOFAS)scores,visual analogue scale(VAS)scores during walking and non weight bearing of patients before operation and at the last follow-up,were recorded and compared,to assess indicators of ankle pain,function,and stability.Results:60 patients were followed up for an average of(31.40±14.39)months.All patients had primary healing of surgical incision,none of the patients had failure of ligament repair until the last follow-up,anterior drawer test and varus stress test were negative(-),and MRI showed healing of the anterior talofibular ligament(ATFL).The AOFAS score at the last follow-up(83.67±6.67)was significantly higher than that before surgery(51.52±14.51),which was statistically significant(P<0.001).The walking VAS score(2.03±1.01)was significantly lower than the preoperative value(5.42±1.11),and the non weight bearing VAS score(1.51±0.95)was also lower than the preoperative value(2.88±0.88),both of which were statistically significant(P<0.001).The radiographic score(1.48±0.81)was not significantly different from the preoperative score(1.23±0.70)(P>0.05).Statistics of skin and subcutaneous tissues in the surgical area showed that 18%of patients had postoperative scars,45%of patients had induration of subcutaneous scars,and only 3 patients reported minor paresthesia in the surgical area skin and 5 patients reported minor pain during surgical incision.Conclusion:The clinical outcomes of ankle arthroscopy assisted Brostrom-Gould operation for CLAI are satisfactory.There is still optimization space of the surgical technique.
作者
邱佳明
白天宇
李紫阁
王宏杰
危一飞
温冠楠
程桯
QIU Jiaming;BAI Tianyu;LI Zige;WANG Hongjie;WEI Yifei;WEN Guannan;CHENG Ting(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国中医骨伤科杂志》
CAS
2023年第7期61-67,共7页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2022-05)。
关键词
踝关节
外踝韧带损伤
慢性踝关节外侧不稳
外踝韧带修复术
ankle joint
lateral ligament injury
chronic lateral ankle instability
brostrom-gould operation
