踝关节镜下韧带增强固定术与距腓前韧带修复术治疗CLAI患者的疗效对比

Comparison of therapeutic effects between ankle arthroscopic ligament reinforcement fixation and anterior talofibular ligament repair in CLAI patients

目的对比观察踝关节镜下韧带增强固定术与距腓前韧带修复术治疗慢性踝关节外侧不稳(CLAI)患者的疗效。方法选取90例CLAI患者,根据手术治疗方法的不同分为韧带固定组(踝关节镜下韧带增强固定术治疗)和韧带修复组(踝关节镜下距腓前韧带修复术治疗)。比较两组围术期指标(手术时间、术中出血量、术后下床时间、恢复正常生活时间及住院时间)。比较两组术前术后踝关节稳定性、踝关节功能、疼痛程度以及两组术后并发症发生情况。结果韧带固定组手术时间、术中出血量、术后下床时间、恢复正常生活时间及住院时间均明显低于韧带修复组(P<0.05)。术后两组踝关节稳定性、踝关节功能及疼痛程度较术前均得到显著改善(P<0.05),且韧带固定组较韧带修复组改善更显著(P<0.05)。两组术后并发症总发生率差异无统计学意义(P>0.05)。结论踝关节镜下距腓前韧带修复术与踝关节镜下韧带增强固定术均能提高CLAI患者踝关节稳定性,改善患者踝关节功能及疼痛程度,但踝关节镜下韧带增强固定术疗效更好。

Aim To compare the efficacy of ankle arthroscopic ligament reinforcement fixation and anterior talofibular ligament repair in the treatment of chronic lateral ankle instability(CLAI)patients.Methods 90 CLAI patients were selected and divided into two groups based on different surgical treatment methods,namely the ligament fixation group(treated with ankle arthroscopic ligament enhancement fixation)and the ligament repair group(treated with ankle arthroscopic anterior talofibular ligament repair).Perioperative indicators(surgical time,intraoperative blood loss,postoperative time to get out of bed,recovery to normal life,and length of hospital stay)were compared between these two groups.The preoperative and postoperative ankle stability,ankle function,pain level,and incidence of postoperative complications were compared between these two groups.Results The surgical time,intraoperative blood loss,postoperative time to get out of bed,recovery time to normal life,and hospital stay in the ligament fixation group were significantly lower than those in the ligament repair group(P<0.05).After surgery,the stability,function,and pain level of the ankle joints in both groups were significantly improved compared with them before surgery(P<0.05),and the improvement in the ligament fixation group was more significant than that in the ligament repair group(P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Both ankle arthroscopic anterior talofibular ligament repair and ankle arthroscopic ligament reinforcement fixation can improve ankle stability,ankle function,and pain in CLAI patients.However,ankle arthroscopic ligament reinforcement fixation has the advantages of better curative efficacy.