缝合锚钉治疗Ⅲ度踝关节外侧副韧带断裂

Treatment for Ⅲ degree lateral ligaments rupture of ankle with suture anchors

目的探讨足-踝关节骨折合并外侧副韧带断裂的手术中用锚钉修复外侧副韧带的方法和治疗效果。方法 2006年5月至2007年10月利用缝合锚钉治疗11例合并外侧副韧带损伤的足-踝关节损伤。踝部按Danis-Weber分型,其中1例A型,4例B型,2例C型,足部距骨骨折2例,跟骨骨折2例,据韧带损伤分型均为Ⅲ度韧带损伤。结果术后患者伤口均Ⅰ期愈合。X线片示11例骨折均达骨性愈合,愈合时间11～16周,平均14.8周。按照AOFAS踝与后足功能评分系统评价术后患足功能,本组优(90～100分)3例,良(75～89分)8例。按照Good踝关节外侧副韧带损伤评价标准评价患足外侧韧带功能,达到Ⅰ级者2人,Ⅱ级者8人,Ⅲ级者1人。结论用缝合锚钉修复足-踝关节骨折伴外侧副韧带Ⅲ度韧带损伤是一种简单高效而并发症较少的手术方式。

Objective To investigate the surgical techniques and the clinical outcomes of treating lateral ligaments rupture of ankle combined with foot-ankle fractures by using suture anchors.Methods From July 2006 to April 2007,11 patients with lateral ligaments rupture of ankle combined with foot-ankle fractures were treated by open reduction and internal fixation with ligament repair by using suture anchors.According to Danis-Weber＇s classification,there were 1cases belonging to type A,6types and 3type C.Besides,there were 3 type talus fractures,1 type calcaneal fractures.According to Classification of ligaments injure,all case were Ⅲ degree of ligament injury.The disease course was from 4 days to 7 days with an average of 5.6 days.Results 11 patients healed by primary healing.The X-ray films showed that all patients achieved bony union.The healing time was 11～16 weeks （mean 14.8 weeks）.According to the Ankle-Hindfoot Scale,the results were excellent in 3 cases,good in 8 cases.According to the criterion of Good,2 cases achievedⅠdegree,8 casesⅡdegree and 1 case Ⅲdegree.Conclusion Using ofsSuture anchors for lateral ligaments rupture of ankle combined with foot-ankle fractures is effective,safe,simple and convenient surgical method,with fewer complications.