踝关节外侧副韧带损伤患者的肌骨超声表现及对康复效果的评价意义

Musculoskeletal Ultrasonography in Patients with Lateral Collateral Ligament Injury of Ankle Joint and Its Significance in Evaluation of Rehabilitation Effect

目的:探讨与分析踝关节外侧副韧带损伤患者的肌骨超声表现及对康复效果的评价意义.方法:选择2020年1月—2022年10月于新疆生产建设兵团第十三师红星医院进行康复治疗的78例踝关节外侧副韧带损伤患者作为研究对象,所有患者都给予关节镜手术检查和肌骨超声检查,观察影像学特征.同时所有患者都给予针灸、推拿的康复治疗,判定康复效果并进行相关性分析等.结果:在78例患者中,关节镜手术判断为肌腱损伤34例、关节腔积液45例、骨折13例、距骨关节软骨病变23例;临床分型:Ⅰ型损伤32例,Ⅱ型损伤28例,Ⅲ型损伤18例.肌骨超声判断为肌腱损伤31例、关节腔积液40例、骨折11例、距骨关节软骨病变20例;临床分型:Ⅰ型损伤35例,Ⅱ型损伤24例,Ⅲ型损伤19例.肌骨超声对于肌腱损伤、关节腔积液、骨折、距骨关节软骨病变的诊断准确性分别为91.2%、88.9%、84.6%、97.0%,肌骨超声对于临床分型的诊断准确性为89.7%.78例患者都完成康复,康复3个月后患者的美国足与踝关节协会(AOFAS)评分都显著高于康复前,差异有统计学意义(P<0.05).Spearman分析显示患者康复3个月后的踝关节AOFAS评分与肌骨超声的肌腱损伤、骨折、距骨关节软骨病变、关节腔积液、临床分型等存在相关性(P<0.05).结论:踝关节外侧副韧带损伤患者的肌骨超声对于临床分型与损伤特征的判断都有较高的准确性,与患者的踝关节AOFAS评分存在相关性,可有效指导康复效果的评价.

Objective:To investigate and analyze the musculoskeletal ultrasonography of patients with lateral collateral ligament injury of ankle joint and its significance in evaluating the rehabilitation effect.Methods:78 patients with lateral ankle collateral ligament injury who received rehabilitation treatment in Hongxing Hospital of the 13th Division of Xinjiang Production and Construction Corps from January 2020 to October 2022 were selected as the study objects.All patients were given arthroscopic surgery and musculoskeletal ultrasound to observe the imaging characteristics.At the same time,all patients were given acupuncture and massage rehabilitation treatment,to determine the rehabilitation effect and correlation analysis.Results:Of the 78 patients,34 were diagnosed with tendon injury,45 with joint effusion,13 with fracture,and 23 with talar articular cartilage disease.Clinical classification:TypeⅠinjury 32 cases,typeⅡinjury 28 cases,typeⅢinjury 18 cases.Musculoskeletal ultrasonography showed tendon injury in 31 cases,articular effusion in 40 cases,fracture in 11 cases,talar articular cartilage disease in 20 cases.Clinical classification:TypeⅠinjury in 35 cases,typeⅡinjury in 24 cases,typeⅢinjury in 19 cases.The diagnostic accuracy of musculoskeletal ultrasound was 91.2%,88.9%,84.6%and 97.0%for tendon injury,joint effusion,fracture and talar articular cartilage disease,respectively,the diagnostic accuracy of musculoskeletal ultrasound for clinical classification was 89.7%.All 78 patients completed rehabilitation,and the American Foot and Ankle Association(AOFAS)scores of all patients were significantly higher after 3 months of rehabilitation than before rehabilitation,with statistical significance(P<0.05).Spearman analysis showed that the ankle AOFAS score 3 months after recovery was correlated with tendon injury,fracture,talus articular cartilage disease,joint effusion and clinical classification of musculoskeletal ultrasound(P<0.05).Conclusion:Musculoskeletal ultrasound of patients with lateral collateral ligament injury of the ankle has high accuracy in clinical classification and injury characteristics,and is correlated with the AOFAS score of patients with ankle joint,which can effectively guide the evaluation of rehabilitation effects.