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自体半腱肌重建外侧副韧带治疗慢性踝关节外侧不稳的疗效分析
Hits: 2137   Download times: 1069   Received:February 06, 2016    
作者Author单位UnitE-Mail
张昊 ZHANG Hao 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
解冰 XIE Bing 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
薛海鹏 XUE Hai-peng 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
杨超 YANG Chao 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
刘兵 LIU Bing 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
马鑫 MA Xin 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
田竞 TIAN Jing 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
周大鹏 ZHOU Da-peng 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China  
项良碧 XIANG Liang-bi 沈阳军区总医院骨科, 辽宁 沈阳 110016 Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China 3022004011@163.com 
期刊信息:《中国骨伤》2017年30卷,第6期,第503-507页
DOI:10.3969/j.issn.1003-0034.2017.06.004
基金项目:2012年辽宁省科技攻关项目(编号:201225041)


目的:探讨采用自体半腱肌重建外侧副韧带治疗慢性踝关节外侧不稳的临床疗效。

方法:回顾性分析2014年9月至2016年11月采用自体半腱肌肌腱重建踝关节外侧副韧带治疗28例踝关节外侧不稳患者的临床资料,其中男20例,女8例;平均年龄28.6岁(18~47岁).记录围术期并发症,并采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝关节评分标准评价术后功能改善情况,采用视觉模拟标尺法(Visual analogue scale,VAS)评估患者术后疼痛情况。

结果:28例患者均获得随访,时间6~28个月,平均18.2个月。围术期未出现医源性骨折及切口感染等严重手术并发症。末次随访时未出现踝关节不稳或踝关节活动受限,未出现膝部肌腱供区肌肉功能障碍。AOFAS评分由术前的53.1±6.8提高至术后的90.4±5.9,差异有统计学意义(P<0.05).VAS评分由术前的6.3±1.7提高至术后的0.8±0.5,差异有统计学意义(P<0.05).

结论:采用自体半腱肌解剖重建踝关节外侧副韧带手术方式简便,术后恢复好,无严重并发症,临床疗效好,是治疗慢性踝关节外侧不稳的可靠方法之一。
[关键词]:踝关节  外侧韧带,踝  修复外科手术
 
Treatment of chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft
Abstract:

Objective: To investigate clinical effects of chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft.

Methods: From September 2014 to November 2016,28 patients with chronic anterolateral ankle instability underwent lateral ligament reconstruction with semitendinosus autograft. Among them,including 20 males and 8 females with an average age of 28.6 years(18 to 47 years old). Preoperative complications were recorded. AOFAS and VAS score were used to evaluate clinical outcomes.

Results: Twenty-eight patients were followed up from 6 to 28 months with an average of 18.2. No iatrogenic fracture or infection occurred. There was no ankle instability or limited at the latest follow-up. AOFAS score was improved from 53.1±6.8 before operation to 90.4±5.9 at the latest follow-up,and had statistical difference(P<0.05); while VAS score was increased from 6.3±1.7 before operation to 0.8±0.5 at the lastest follow-up(P<0.05).

Conclusion: Chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft has advantages of simple operation,good recovery,less compilations and good clinical effects. It is one of stable methods for the treatment of chronic anterolateral ankle instability.
KEYWORDS:Ankle joint  Lateral ligament,ankle  Reconstruction surgical procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:张昊,解冰,薛海鹏,杨超,刘兵,马鑫,田竞,周大鹏,项良碧.自体半腱肌重建外侧副韧带治疗慢性踝关节外侧不稳的疗效分析[J].中国骨伤,2017,30(6):503~507
英文格式:ZHANG Hao,XIE Bing,XUE Hai-peng,YANG Chao,LIU Bing,MA Xin,TIAN Jing,ZHOU Da-peng,XIANG Liang-bi.Treatment of chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(6):503~507
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