自体半腱肌腱解剖重建距腓前韧带及跟腓韧带治疗踝关节外侧不稳的临床研究

The clinical research of surgical treatment for lateral ankle instability by body semitendinosus tendon anatomical reconstruction of the anterior talofibular ligament and calcaneofibular ligament

目的观察采用自体半腱肌腱解剖重建距腓前韧带及跟腓韧带治疗踝关节外侧不稳的临床疗效。方法自2010年10月～2012年7月收治踝关节外侧不稳的患者18例,年龄15～42岁,平均23.6岁。所有患者行踝关节镜探查清理并取自体半腱肌腱解剖重建距腓前韧带及跟腓韧带,手术前后按踝关节评分系统评分。结果18例患者术后平均随访13个月(3～20个月),随访期间踝关节活动度基本恢复正常,没有复发性踝关节不稳发生。美国足踝外科(AOFAS)踝-后足功能评分由术前(50.4±4.5)分提高至术后(83.5±7.2)分,随访期间未发现踝关节不稳复发及其他并发症。结论自体半腱肌腱解剖重建踝关节距腓前韧带及跟腓韧带,能有效恢复踝关节外侧不稳定。

Objective To observe the clinical effect of surgical method treatment for chronic anterolateral ankle insta- bility, in which anterior talofibuiar and calcaniofibular ligaments were reconstructed using the semitendinosus tendon. Methods Eighteen cases of anterolateral ankle instability were treated from October 2010 to July 2012. Eighteen cases with an average age of 23.6 years. All patients underwent ankle the arthroscopic exploration cleanup and taken from the body semitendinosus anatomic reconstruction of the anterior talofibular ligament and calcaneofibular ligament. The ankle scoring system was used to evaluate ankle joint function before and after operation. Results All patients were followed up 3-20 months with an average of 13 months. The range of motion was generally recovered without recurrent instability during the follow up peroid. The AOFAS score was improved from （50.4±4.5）to （83.5±7.2）. Conclusion Reconstruction the anterior talofibular and calcaniofibular ligamnets by using the semitendinosus tendon can result in effective ankle stability.