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[1]李琦,尚林,馬富強,等.第三腓骨肌肌腱解剖重建距腓前韌帶治療陳舊性距腓前韌帶損傷[J].中醫(yī)正骨,2021,33(04):71-74.
 LI Qi,SHANG Lin,MA Fuqiang,et al.Anatomical reconstruction of anterior talofibular ligaments with peroneus tertius tendon for treatment of old anterior talofibular ligament injuries[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(04):71-74.
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第三腓骨肌肌腱解剖重建距腓前韌帶治療陳舊性距腓前韌帶損傷()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年04期
頁碼:
71-74
欄目:
臨床報道
出版日期:
2021-04-20

文章信息/Info

Title:
Anatomical reconstruction of anterior talofibular ligaments with peroneus tertius tendon for treatment of old anterior talofibular ligament injuries
作者:
李琦尚林馬富強張小龍王亞磊孫士強賈光輝王翔宇
(鄭州市骨科醫(yī)院,河南 鄭州 450052)
Author(s):
LI QiSHANG LinMA FuqiangZHANG XiaolongWANG YaleiSUN ShiqiangJIA GuanghuiWANG Xiangyu
關(guān)鍵詞:
踝損傷 外側(cè)韌帶 距腓前韌帶 第三腓骨肌 移植自體
摘要:
目的:觀察第三腓骨肌肌腱解剖重建距腓前韌帶治療陳舊性距腓前韌帶損傷的臨床療效和安全性。方法:2016年5月至2019年7月,采用第三腓骨肌肌腱解剖重建距腓前韌帶治療陳舊性距腓前韌帶損傷患者16例,男9例、女7例。年齡20~55歲,中位數(shù)36歲。體質(zhì)量指數(shù)18.6~33.7 kg·m-2。所有患者半年內(nèi)有2次以上的嚴(yán)重踝關(guān)節(jié)扭傷史,經(jīng)正規(guī)非手術(shù)療法治療后無效,且行改良Brostr?-Gould修復(fù)術(shù)失敗。X線檢查均顯示距骨前移>10 mm,距骨傾斜角>9°; MRI檢查提示距腓前韌帶伴或不伴跟腓韌帶斷裂,且第三腓骨肌存在。所有患者前抽屜試驗和內(nèi)翻應(yīng)力試驗均為陽性。踝關(guān)節(jié)初次扭傷至手術(shù)時間 12~24個月,中位數(shù)18個月。采用疼痛視覺模擬量表(visual analogue scale,VAS)評分評價踝關(guān)節(jié)疼痛情況,采用美國足與踝關(guān)節(jié)協(xié)會(American Orthopaedic Foot and Ankle Society,AOFAS)踝與后足功能評分和足踝功能測試(foot and ankle ability measure,FAAM)評分評價踝關(guān)節(jié)功能恢復(fù)情況,并隨訪觀察并發(fā)癥發(fā)生情況。結(jié)果:本組患者手術(shù)時間65~90 min,中位數(shù)70.5 min。切口均甲級愈合,前抽屜試驗和內(nèi)翻應(yīng)力試驗均為陰性。所有患者均獲得隨訪,隨訪時間12~20個月,中位數(shù)18個月。踝關(guān)節(jié)疼痛VAS評分,術(shù)前(6.13±0.64)分、術(shù)后1年(1.33±0.74)分; AOFAS踝與后足功能評分,術(shù)前(52.47±7.37)分、術(shù)后1年(89.23±5.75)分,優(yōu)11例、良5例; FAAM評分,術(shù)前(58.67±5.70)分、術(shù)后1年(90.13±6.60)分,優(yōu)9例、良7例。均無感染、神經(jīng)損傷等并發(fā)癥發(fā)生。結(jié)論:采用第三腓骨肌肌腱解剖重建距腓前韌帶治療陳舊性距腓前韌帶損傷,能緩解踝關(guān)節(jié)疼痛,促進踝關(guān)節(jié)功能恢復(fù),且并發(fā)癥少。

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備注/Memo

備注/Memo:
基金項目:河南省醫(yī)學(xué)科技攻關(guān)計劃項目(201503237)
通訊作者:王翔宇 E-mail:[email protected]
更新日期/Last Update: 1900-01-01