距跟外侧韧带替代法治疗跟腓韧带缺失的慢性踝关节外侧不稳

Treatment of Calcaneofibular Ligament Deficiency-induced Chronic Ankle Lateral Instability Using the Lateral Talocalcaneal Ligament

目的:研究距跟外侧韧带替代法治疗跟腓韧带缺失的慢性踝关节外侧不稳的疗效。方法:32例慢性踝关节外侧不稳患者,平均年龄26.4±8.7岁,接受踝关节外侧韧带修复手术。术中证实所有患者的跟腓韧带均缺失,采用距跟外侧韧带距骨止点移位替代法修复跟腓韧带。研究平均随访22.3±4.0个月,术前和术后进行AOFAS评分、Mazur评分、Tegner评分、客观检查(前抽屉试验和内翻应力试验)、满意度评分,调查再伤情况。结果:所有患者AOFAS评分、Mazur评分和Tegner评分均显著高于术前,客观检查(抽屉试验和侧搬应力试验)术后均为阴性,满意度评分平均7.4分,无主观不稳和再伤发生,无距下关节(跗骨窦区)疼痛或/和不稳发生。结论:距跟外侧韧带替代法治疗跟腓韧带缺失的慢性踝关节外侧不稳具有良好的治疗效果,临床观察对距下关节无明显影响。

Objective To explore the outcomes of treating calcaneofibular ligament（CFL）deficiency-induced chronic ankle instability using the lateral talocalcaneal ligament. Method 32 consecutive patients with CFL deficiency-induced chronic ankle instability were repaired with lateral talocalcaneal ligament and followed up for an average of 22.3 ± 4.0 months. Their defects of CFL were confirmed during the operation and repaired with transferring the talar insertion of the lateral talocalcaneal ligament to the fibula. The AOFAS score, Mazur score, Tegner score, objective examinations（including drawer test and inversion stress test）,satisfaction score and reinjured history were used to evaluate the clinical outcomes. Result At the follow up,the AOFAS score, Mazur score and Tegner score improved significantly,negative anterior drawer test and inversion stress test were found,the satisfaction score was 7.4 point,and no instability, reinjury or subtalar pain occurred. Conclusion Transferring the lateral talocalcaneal ligament to repair the calcaneofibular ligament deficiency-induced chronic ankle instability achieved ideal clinical effect with no influence on normal function of subtalar joint.