踝关节镜下清理术及小切口辅助外侧副韧带重建术后的康复研究

Rehabilitation after Ankle Arthroscopic Debridement and in Small Incision Lateral Ankle Ligamentous Reconstruction through Small Incision

目的:研究踝关节清理术及外侧副韧带重建术后康复治疗计划。方法:将36例踝关节镜下外侧副韧带重建术后的患者随机分为康复治疗组和对照组,其中康复治疗组20例、对照组16例。两组患者均采用常规的非甾体类抗炎药物和短波、脉冲磁疗、半导体激光治疗。康复治疗组同时按踝关节镜下清理术及小切口辅助外侧副韧带重建术后康复治疗计划进行康复训练,采用改良McGuire踝关节评分系统(1988)评估其疗效。对两组患者分别于术后4、8、12、16和24周进行疗效观察和功能评定。结果:两组患者术后4周踝关节功能评分无显著性差异(P>0.05);术后8周,康复治疗组踝关节功能评分较对照组有所提高,但无显著性差异(P>0.05);术后12周、16周和24周康复治疗组踝关节功能评分与对照组相比有明显改善,具有显著性差异(P<0.05,或P<0.01)。结论:根据踝关节及其外侧副韧带损伤的特点和手术方式,设计科学、系统、安全、有效的踝关节镜下清理术及小切口辅助外侧副韧带重建术后的康复治疗计划,并据此对术后患者进行系统的康复训练,对踝关节功能的恢复有明显促进作用。

Objective To study the effects of rehabilitation exercise training on the recovery of ankle joint function after ankle arthroscopic debridement and lateral ankle ligamentous reconstruction through small incision.Methods Thirty six cases of the lateral ankle ligament injury after reconstruction of the lateral ankle ligament were divided into rehabilitation training group（20 cases） and control group（16 cases） in random manner.Patients of rehabilitation training group were started rehabilitation training after 3 day of reconstruction of the lateral ankle ligament.McGuire scores and the visual analog scale（VAS） were adopted for evaluation after surgery in 8,12,16 weeks and 24 weeks.Results Compared with control guoup,rehabilitation training group were satisfied with the good function of the ankle joints pain relief and McGuire scores（P 〈0.05 or P 〈0.01）after reconstruction 12,16 and 24 weeks.Conclusion This study indicated that rehabilitation training could significantly improve ankle joint function after reconstruction of the lateral ankle ligament.