高频超声测量距腓前韧带损伤后健侧与病侧韧带厚度的变化

An investigation into the changes of ligament thickness after anterior tibiofibular ligament injury measured by high frequency ultrasound

目的比较距腓前韧带(anterior talofibular ligament,ATFL)Ⅰ型、Ⅱ型及Ⅲ型损伤后健侧与病侧韧带厚度变化及伴有跟腓韧带(calcaneofibular ligament,CFL)损伤率。方法选取2018年1—6月在中国科学技术大学附属第一医院安徽省立医院南区就诊的单侧踝关节韧带损伤病人91例,均行高频超声检查并分型,分别测量并比较ATFLⅠ型、Ⅱ型及Ⅲ型损伤病侧与健侧韧带厚度,同时观察是否伴有CFL损伤。结果91例ATFL损伤病例中Ⅰ型损伤47例[51.61%(47/91)],Ⅱ型损伤31例[34.07%(31/91)],Ⅲ型损伤13例[14.29%(13/91)],伴有CFL损伤31例[34.07%(31/91)]。健侧韧带厚度(2.00±0.44)mm,病侧韧带厚度(2.73±0.94)mm,差异有统计学意义(t=5.19,P<0.05)。Ⅰ、Ⅱ及Ⅲ型损伤病侧韧带厚度均大于健侧,差异有统计学意义,Ⅰ型损伤(t=3.61,P<0.05),Ⅱ型损伤(t=2.86,P<0.05),Ⅲ型损伤(t=2.68,P<0.05)。两两比较Ⅰ、Ⅱ及Ⅲ型韧带健侧厚度比较,差异无统计学意义(F=1.73,P>0.05),Ⅰ、Ⅱ及Ⅲ型韧带病侧厚度比较,差异无统计学意义(F=0.95,P>0.05)。Ⅰ型、Ⅱ型及Ⅲ型韧带损伤与伴有CFL损伤率间比较,差异有统计学意义(χ2=9.66,P<0.05)。结论高频超声在踝关节韧带损伤的诊断中有较高价值,ATF损伤后韧带厚度较健侧增加,Ⅱ型和Ⅲ型损伤伴有CFL损伤的可能性大于Ⅰ度损伤。

Objective To explore the thickness changes after typeⅠ,typeⅡand typeⅢanterior talofibular ligament(ATFL)in jury and compare the rate of the calcaneofibular ligament(CFL)injured.Methods A total of 91 cases with ankle ligament injury treated in our hospital from January 2018 to June 2018 were selected.The high frequency ultrasonography was utilized to check and diagnose the ATFL injury(typeⅠ,typeⅡor typeⅢ)of all cases.The thickness of normal ligament and affected ligament were measured,and observed whether there was CFL injury.Results Among the selected 91 cases with ATFL injury,47 cases were typeⅠ[51.61%(47/91)],31 cases]were typeⅡ[34.07%(31/91),13 cases were typeⅢ[14.29%(13/91)],31 cases were concom itant CFL injury[34.07%(31/91)].The thickness of normal ligament was(2.00±0.44)mm,the affected ligament was(2.73±0.94)mm.Statistical significance was achieved(t=5.19,P<0.05).Type I,typeⅡand typeⅢwas thicker than the normal side,statisti cal significance was reached,where typeⅠ(t=3.61,P<0.05),typeⅡ(t=2.86,P<0.05)and typeⅢ(t=2.68,P<0.05).No statistical significance was attained in the pairwise comparison between the normal ligament thickness of typeⅠ,typeⅡand typeⅢ(F=1.73,P>0.05).A similar conclusion could be drawn(no statistical significance)in the pairwise comparison between affect ed ligament thickness of typeⅠ,typeⅡand typeⅢ(F=0.95,P>0.05).Statistically significance was fulfilled between the typeⅠ,typeⅡ,typeⅢand concomitant CFL injury rate(χ2=9.66,P<0.05).Conclusion High frequency ultrasound has a great val ue in the diagnosis of ankle ligament injury.The thickness of ligament is increased after ATFL injury,and the possibility of concom itant CFL injury is higher with typeⅡand typeⅢthan typeⅠ.