慢性踝外侧不稳定韧带重建术的研究进展

Research progress in ligament reconstruction for chronic lateral ankle instability

慢性踝外侧不稳定(chronic lateral ankle instability,CLAI)多继发于踝关节急性扭伤,是踝关节运动系统损伤中最常见的问题之一。约30%的患者保守治疗无效并反复迁延发展为CLAI,需要手术治疗。改良的Brostr?m解剖修复技术被认为是治疗CLAI的金标准。然而临床上很多患者并不适合直接修复损伤的韧带,此时采用移植物进行韧带重建是一个更好的选择。重建方案可分为解剖重建和非解剖重建,而移植物的选择主要有自体肌腱与同种异体肌腱两种。近年来外踝韧带重建技术一直在不断发展。本文就踝外侧韧带重建术治疗CLAI进行综述,为临床诊治提供依据。

Chronic lateral ankle instability(CLAI) is often secondary to acute ankle sprain,which is one of the most common problems in ankle injury.About 30 percent of patients develop CLAI after failure of primary conservative treatments and need surgery.Modified Brostr?m anatomical repair techniques have traditionally been considered the gold standard for treating CLAI.However,many patients are not suitable for direct repair of damaged ligaments in clinical practice,ligament reconstruction with grafts might be a better choice.Reconstructions are divided into anatomical and non-anatomical projects,and the choice of grafts mainly includes autograft and allograft.The technique of lateral ankle ligament reconstruction has been developing in recent years.This article reviews CLAI for reconstruction of lateral ligament to provide basis for clinical treatment.