膝关节内、外翻角度对踝关节扭伤类型及次数的影响

Influence of knee joint varus-valgus angle on type and frequency of ankle sprain

目的 分析膝关节内、外翻角度对踝关节扭伤类型及次数的影响。方法 回顾性分析自2015-05—2022-05于昆明市中医医院就诊的742例单纯踝关节扭伤患者。查阅相关病案资料获得踝关节扭伤具体诊断、扭伤次数和股胫角等数据,根据股胫角参数定义将患者分为膝内翻组、膝外翻组、正常股胫角组,比较各组外踝损伤、内踝损伤和内外踝合并损伤情况、踝关节扭伤次数、各组发生外踝损伤的类型差异和外踝扭伤次数的差异。结果 所有患者根据膝关节正位片测量的股胫角分为膝内翻组(n=103)、膝外翻组(n=245)、正常股胫角组(n=394),3组外踝损伤、内踝损伤、内外踝合并损伤例数差异有统计学意义(P<0.05),膝内翻组的外踝损伤比例较膝外翻组高。3组踝关节扭伤次数差异有统计学意义(P<0.05),膝内翻组2次及≥3次踝关节扭伤比例较膝外翻组高。3组外踝损伤各亚型比例、外踝损伤扭伤次数差异有统计学意义(P<0.05),膝内翻组发生2次及≥3次外踝扭伤的比例明显高于正常股胫角组。结论 膝关节股胫角水平可显著影响踝关节损伤类型,膝内翻畸形患者更容易出现以距腓前韧带损伤为主的外踝甚至反复外踝损伤。

Objective To analyze the influence of knee joint varus-valgus angle on the type and frequency of ankle sprain.Methods A retrospective analysis was conducted on 742 patients with simple ankle sprain from Kunming Hospital of Traditional Chinese Medicine (Chenggong Branch) from May 2015 to May 2022.The data of ankle sprain diagnosis,sprain frequency,and femoral tibial angle were obtained through reviewing relevant medical records.The patients were divided into varus knee group,valgus knee group,and normal femoral tibial angle group according to the definition of femoral tibial angle.The lateral malleolus injury,medial malleolus injury,and combined injury of lateral and medial malleolusi,were compared among the three groups,as well as the differences in the types and the number of lateral malleolus injuries in each group were compared.Results All patients were divided into varus knee group (n=103),valgus knee group (n=245),and normal femoral tibial angle group (n=394) according to the measurement of femoral tibial angle on knee joint anteroposterior X-ray.There was a statistically significant difference in the number of lateral malleolus injury,medial malleolus injury,and combined injury of lateral and medial malleoli among the three groups (P<0.05),and the proportion of lateral malleolus injury in varus knee group was higher than that in valgus knee group.There was a statistically significant difference in the frequency of ankle sprain among the three groups(P<0.05),and the proportion of ankle sprain≥2 times in varus knee group was higher than that in valgus knee group.There was a statistically significant difference in the proportion of each subtype of lateral malleolus injury and the frequency of lateral malleolus injury among the three groups (P<0.05),and the proportion of patients with≥2 ankle sprains in varus knee group was significantly higher than that in normal femoral tibial angle group.Conclusion The level of femoral tibial angle can significantly affect the type of ankle injury,and patients with varus knee deformity are more prone to lateral malleolus injury mainly involving anterior talofibular ligament and even repeated lateral malleolus injury.