带线锚钉结合改良Gould-Brostr m术修复踝关节外侧副韧带治疗CLAI的疗效观察

Efficacy of lateral collateral ankle ligament repair with suture anchor combined with modified Gould-Brostr m surgery in the treatment of CLAI

目的:观察带线锚钉结合改良Gould-Brostr m术修复踝关节外侧副韧带治疗踝关节外侧不稳(CLAI)的疗效。方法:选取81例CLAI患者为研究对象,按照手术方式不同分为观察组(n=41)和对照组(n=40)。观察组患者行带线锚钉+改良Gould-Brostr m术;对照组患者行传统改良Gould-Brostr m术。比较两组患者手术时间、伤口愈合时间及术后恢复正常活动时间;随访1年,比较术前与末次随访时踝关节功能恢复情况、距骨倾斜角和距骨前移距离及随访期间完全负重后的并发症。结果:两组患者手术时间比较,差异无统计学意义(P>0.05);观察组患者伤口愈合时间及恢复正常活动时间短于对照组(P<0.05)。观察组患者末次随访时美国骨科足踝外科协会踝与后足评分(AOFAS)评分、卡尔森踝关节功能评分(KAFS)高于对照组(P<0.05);距骨倾斜角及距骨前移距离小于对照组(P<0.05)。两组患者疼痛视觉模拟评分(VAS)评分及随访期间完全负重后并发症比较,差异无统计学意义(P>0.05)。结论:带线锚钉结合改良Gould-Brostr m术能够缩短踝关节功能修复时间,在改善踝关节功能稳定方面具有一定优势,值得临床推广。

Objective:To observe the efficacy of suture anchor combined with modified Gould-Brostr m surgery to repair the lateral collateral ankle ligament in the treatment of chronic lateral ankle instability(CLAI).Methods:81 patients with CLAI were selected as the research objects.According to the surgical methods,the patients were divided into observation group(suture anchor+modified Gould-Brostr m surgery,n=41)and control group(traditional modified Gould-Brostr m surgery,n=40).The surgical time,wound healing time and postoperative normal activity recovery time were compared between the two groups.After 1 year of follow-up,the ankle function recovery of the two groups of patients was observed before surgery and at the last follow-up.The talar tilt angle and anterior talar translation were measured on the stress position X-ray films of malleolus varus on the affected sides of the two groups,and the occurrence of complications after complete weight-bearing were statistically analyzed during follow-up in the two groups.Results:There was no statistically significant difference in the surgical time between the two groups(P>0.05),the wound healing time and normal activity recovery time in observation group were shorter than those in control group(P<0.05)The American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and Karlsson Ankle Function Score(KAFS)in observation group at the last follow-up were higher than those in control group(P<0.05).The talar tilt angle and anterior talar translation were smaller in observation group than those in control group(P<0.05).There was no statistical significance in the score of Visual Analogue Scale(VAS)and the complications after complete weight-bearing during follow-up between the two groups(P>0.05).Conclusion:Suture anchor combined with modified Gould-Brostr m surgery can shorten the repair time of ankle function,and has certain advantages in improving the stability of ankle function,which is worthy of clinical promotion.