改良Evans手术重建踝关节外侧副韧带

Reconstruction of the lateral ligament of ankle joint with Evans procedure

目的 :探讨用改良Evans手术重建踝关节外侧副韧带的疗效。方法 :对 4 2例陈旧性踝关节外侧副韧带损伤的病人行改良Evans手术。常规暴露后 ,将腓骨短肌腱于腱腹处切断 ,自外踝尖端在腓骨内向后上方钻孔 ,将肌腱部分引出骨道并固定于腓骨骨膜上。全部病例从损伤至重建术的时间为 4～ 1 1个月 ,平均 7个月 ,随访 2～ 6年 ,平均 4 .8年。结果 :按Good评价标准达到Ⅰ级者 8人 ,Ⅱ级者 1 8人 ,Ⅲ级者 1 2人 ,Ⅳ级者 4人。X片显示有 4人出现踝关节的退变。结论 :改良Evans手术虽然明显改善了外踝的稳定性 。

Objective: To describe the modified Evans technique for treatment of old injuries of the lateral ligament of the ankle. Methods: 42 ankles with old injuries of the lateral ligament underwent ligament reconstruction using modified Evans.The tendon of peroneus brevis was divided just below the musculotendinous junction.A 3.5mm hole was drilled into the fibula,passing the tendon through the tunnel and suturing to the periosteum of the fibula.All patients were delayed in treatment for 4～11 months.The duration of follow-up was 2～6 years. Results: According to the criterion of good, 42 patients,8 were excellent,12 good,18 fair and 4 poor.The radiographs show that 4 patients had degenerative changes. Conclusions: Although the modified Evans improved stability of the ankles,it didn't relieve pain satisfactorily.