手术治疗慢性踝关节外侧不稳106例

Treatment for chronic anterolateral ankle instability in 106 patients with surgical method

目的探讨慢性踝关节外侧不稳继发病损及其有效的手术方法。方法 本组行手术解剖重建外踝韧带治疗慢性踝关节外侧不稳的患者106例,观察其继发病损在关节镜下的表现。结果 对本组患者随访12～111个月,平均31.2个月,术后所有踝关节均达到功能稳定,关节活动度基本恢复正常,没有复发性踝关节不稳发生。运用美国AOFAS足踝评分系统对患者手术前后踝关节功能进行评估,术前与术后AOFAS后足评分间的差异有统计学意义。结论 解剖重建距腓前韧带、跟腓韧带,有效地矫正了踝关节外侧不稳定和距下关节不稳定,是治疗踝关节慢性前外侧严重不稳定的合理而有效的治疗方法。

Objective To discuss secondary lesion and effective surgical method for the treatment of chronic anterolateral ankle instability. Methods From 1997 to 2007, reconstruction was used in surgical treatment for chronic anterolateral ankle instability in 106 patients, and secondary lesion was observed by arthroscopy. Results Postoperative follow-up time was from 12 to 111 months, with an average of 30. 2 months. Functional stabilitywas achieved and range of motion generally recovered without recurrent instability. The therapeutic results were evaluated with grading scale developed by AOFAS et al. There were significant differences in AOFAS values before and after operation. Conclusions With reconstruction technique, anterior talofibular and calcaniofibular ligaments can all be reconstructed, so that both lateral and subtalar instability of ankle can be restabilized effectively. It is a reasonable and effective surgical method for the treatment of chronic anterolateral ankle instability.