关节镜下距腓前韧带联合跟腓韧带重建在踝关节外侧不稳患者中的应用研究

Application of arthroscopic anterior tibiofibular ligament and calcaneofibular ligament reconstruction in patients with lateral ankle instability

目的本研究旨在探讨关节镜下距腓前韧带联合跟腓韧带重建在踝关节外侧不稳患者中的应用情况。方法选择踝关节外侧不稳患者102例,将其随机分为观察和对照组,每组各51例。对照组采用Brostrom踝关节外侧韧带重建术,观察组采用关节镜辅助距腓前韧带与跟腓韧带重建术。记录患者的围手术期指标,通过视觉模拟评分(VAS)评估患者手术前后的疼痛情况,并比较患者术前和术后12个月的踝关节功能、踝关节活动度,并进行正前方、正后方、后外侧45°星状伸展平衡试验(SEBT),记录术后不良反应(感染、神经损伤、关节僵硬)。结果观察组手术时间更长,但术后恢复时间、术后VAS评分均低于对照组,且观察组术后距骨倾斜角、距骨前移距离低于对照组,踝关节功能、跖屈角度、背伸角度、SEBT均比对照组提高。结论关节镜辅助距腓前韧带与跟腓韧带重建术有助于提高踝关节外侧不稳患者的治疗效果,改善关节活动度。

Objective To assess the clinical outcomes of arthroscopic reconstruction for anterior talofibular and calcaneofibular ligaments in managing lateral ankle instability.Methods A total of 102 patients with lateral ankle instability were selected as the research subjects.They were divided into two groups(n=51).The control group underwent the Brostrom procedure for lateral ankle ligament reconstruction,while the observation group received arthroscopy-assisted anterior talofibular and calcaneofibular ligament reconstruction.Perioperative indicators were compared between the two groups.The pain situation before surgery and after surgery was assessed using the VAS.The ankle function and range of motion of the ankle joint were compared before and 12 months after surgery,and the 45°stellate extension balance test(SEBT)was performed in anteriorly,posteriorly and posterolaterally.Postoperative adverse reactions(infection,nerve damage,joint stiffness)were also recorded.Results The operation time of the observation group was longer,but the postoperative recovery time and postoperative VAS score were lower than those of the control group.The postoperative talar inclination angle and talar anterior displacement distance of the observation group were lower than those of the control group.The ankle function,plantar flexion angle,dorsiflexion angle,and SEBT of the observation group were all improved compared with those of the control group.Conclusion Reconstruction of anterior talofibular and calcaneofibular ligaments via arthroscopy can bolster treatment results for those with lateral ankle instability,augmenting joint flexibility.