腓骨短肌肌腱动力重建军事训练伤后踝关节外侧慢性不稳  

Treatment of chronic lateral instability of ankle joint caused by military training injury by dynamic reconstruction of peroneus brevis tendon

作　　者：周全[1] 邬建明[1] 王世魁[1] 黄伟[1] 陈燕才[1] 王伟[1] 

机构地区：[1]解放军59医院骨病关节外科,云南开远661600

出　　处：《西南国防医药》2013年第10期1068-1070,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨军事训练伤后踝关节外侧慢性不稳的手术方法。方法对18例军事训练伤致踝关节外侧慢性不稳患者进行手术干预，术中采用自体腓骨短肌肌腱重建距腓前韧带和跟腓韧带，韧带止点处用骨锚钉固定，术后根据AHS评分进行疗效评估。结果术后16例获得6—14个月随访，12W时均已恢复完全负重行走，X线下内翻应力试验、抽屉试验阴性，6个月时恢复正常生活和训练；AHS评分，术前为（46．25±4．17）分，术后为（86．17±7．23）分，术前、术后有显著差异（P〈0．01）。术后患者踝关节稳定，功能良好。结论军事训练伤后踝关节外侧慢性不稳应首选手术治疗，用腓骨短肌肌腱动力重建距腓前韧带及跟腓韧带疗效确切。Objective To investigate the surgical treatment of chronic lateral instability of the ankle joint caused by military training injury. Methods Eighteen patients with chronic lateral instability of the ankle joint caused by military training received the surgical operation. During the operation, autologous peroneus brevis tendon was used to reconstruct anterior talofibular ligament and calcaneofibular ligament at the same time. The ligament was fixed by bone rivets. After the operation, the therapeutic effects were evaluated by Ankle Hindfoot Scale （AHS）. Results After the operation, 16 cases received the follow-up for 6-14 months. At the time of 12 weeks,they all regained their weight-bearing and walking ability. The results of varus stress test and drawer test were negative under X-ray. They returned to normal life and work at the sixth month. AHS scores were（46.25 _＋ 4.17） points before the operation and（86. 17 ＋ 7.23 ）points after the operation. And there were significant differences in those scores before and after the operation（ P 〈 0.01 ）. The condition of ankle joint was stable, and the function was good after the operation. Conclusion Surgical treatment is the first choice for chronic lateral instability of the ankle joint caused by military- training. Reconstruction of anterior talofibular ligament and calcaneofibular ligament by peroneus brevis tendon has definite therapeutic effect.

关 键 词：训练伤 踝关节 不稳定 腓骨 短肌腱 动力重建 

分 类 号：R684[医药卫生—骨科学]