腓骨短肌肌腱转位加锚钉缝合治疗Ⅲ度踝关节外侧副韧带损伤的疗效观察  

Clinical Effect Observation of Transposition of Peroneus Brevis Combined with Anchor Suture in Degree Ⅲ Lateral Ligament Injury of Ankle

作　　者：刘联彬[1] 梁比记 

机构地区：[1]广东省第二中医院骨二科,广东广州510095 [2]东莞市凤岗镇人民医院骨科,广东东莞523695

出　　处：《临床医学工程》2012年第12期2130-2132,共3页Clinical Medicine & Engineering

摘　　要：目的探讨采用腓骨短肌肌腱转位加缝合锚钉治疗Ⅲ度踝关节外侧副韧带损伤的临床疗效。方法采用前瞻性随机对照的研究方法,比较采用腓骨短肌肌腱转位加缝合锚钉与采用护踝保护治疗踝关节外侧副韧带Ⅲ度损伤的疗效,两种治疗方法分别分为治疗组及对照组,两组病例各12例。所有病例治疗后随访2年。采用Baird-Jackson踝关节评分系统评价踝关节功能。结果两组Baird-Jackson踝关节评分总分治疗前与治疗后各时间段随访评分比较均有明显改善(P<0.01)。治疗组手术后各时间段的Baird-Jackson踝关节评分总分较对照组有所提高,差异均具有统计学意义(P<0.05);在分项目评分中,治疗组术后3月的稳定性和放射学评分较对照组显著提高,差异有显著统计学意义(P<0.01);随访2年,除活动范围评分外,其它项目评分治疗组均比对照组高,差异有统计学意义(P<0.05)。并发症方面,治疗组有1例出现腓肠神经损伤,经治疗后可恢复。结论采用腓骨短肌转位加缝合锚钉解剖重建踝关节距腓前韧带、跟腓韧带是安全、有效的,可以明显地改善踝关节的功能。Objective To explore the clinical effect ofperoneus brevis transposition and anchor suture in treating degree III lateral ligament injury of ankle. Methods Comparing the efficacy of peroneus brevis transposition and anchor suture with immobilization in treating degree III lateral ligament injury of ankle in a prospective randomized controlled study. All cases were divided into the treatment group and the control group, each of which contained 12 cases. All cases underwent a 2-year follow-up study assessing the ankle function by Baird-Jackson scoring system. Results Overall Baird-Jackson scores were remarkably improved after treatment compared with beginning in both groups at the end of follow-up period （P 〈0.01）. The after-treatment Baird-Jackson scores were improved in the treatment group than those in the control group, and the difference was of statistical significance （P 〈0.05）. In the subdivision scoring, the stability scores and the radiology scores of the treatment group were improved dramatically after three months with a difference of statistical significance （P 〈0.01）. Except for the range-of-activity scores, other rating scores in the Baird-Jackson rating system were higher in the treatment group than those in the control group at the end of a 2-year follow-up （P 〈0.05）. In the realm of complications, one case occurred with sural nerve injury in the treatment group, which recovered after treatment. Conclusions Reconstruction of anterior talofibular ligament and calcaneofibular ligament by using peroneus brevis transposition and anchor suture is safe and effective, and it can improve the ankle function significantly.

关 键 词：腓骨短肌肌腱转位 缝合锚钉 踝关节外侧副韧带损伤 

分 类 号：R816.8[医药卫生—放射医学]