全镜下无线结锚钉修复距腓前韧带的手术技术  

Arthroscopic anterior talofibular ligament repair with a knotless suture anchor for chronic ankle lateral instability

作　　者：黄雯洁 黄若昆 雷波 刘丰 欧阳斐 潘昊[1] 谢鸣 HUANG Wen-jie;HUANG Ruo-kun;LEI Bo;LIU Feng;OUYANG Fei;PAN Hao;XIE Ming(The Fourth Hospital of Wuhan City,Puai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,China)

机构地区：[1]武汉市第四医院,华中科技大学同济医学院附属普爱医院,武汉430033

出　　处：《中国矫形外科杂志》2020年第16期1504-1507,共4页Orthopedic Journal of China

摘　　要：[目的]介绍关节镜下无线结锚钉修复距腓前韧带治疗慢性踝关节外侧不稳的手术技术及临床疗效。[方法]回顾性分析2016年2月~2017年10月收治的15例患者。均因踝关节扭伤致踝关节外侧疼痛、不稳就诊,正规保守治疗6个月以上无效,术前踝关节前抽屉试验与内翻应力试验(+),全镜下关节腔清理,距腓前韧带双线环套后收紧止点处置入可吸收无结锚钉1枚,恢复韧带张力。[结果]平均随访(14.56±2.32)个月。AOFAS踝-后足功能评分由术前(45.34±3.41)分提高至末次随访时(96.68±2.32)分。VAS评分由术前(5.68±1.76)分降至(1.56±1.36)分。无伤口并发症发生,无皮神经损伤,无再发不稳定。所有患者主观感觉踝关节稳定性提高。[结论]应用关节镜无线结锚钉技术修复慢性踝关节外侧不稳创伤小,解剖修复,安全可靠,近期疗效满意。[Objective]To introduce surgical technique and clinical outcomes of arthroscopic anterior talofibular ligament(ATFL)repair with a knotless suture anchor for chronic ankle lateral instability.[Methods]A total of 15 patients underwent this surgical procedure.All the patients suffered from lateral ankle pain and instability with positive ankle drawer test and varus stress test secondary to ankle sprains,and failed in regular conservative treatment for more than 6 months.Under arthroscope,debridement was conducted and a knotless suture anchor was inserted on the fibular attachment of ATFL to reattached the torn ligament in proper tension.[Results]All the patients were followed up for(14.56±2.32)months on an average.The AOFAS ankle and foot score significantly increased from(45.34±3.41)preoperatively to(96.68±2.32)at the latest follow up,while the VAS score significantly decreased from(5.68±1.76)before operation to(1.56±1.36)at the latest follow up.No serious complications,such as incision infection,cutaneous nerve injuries and recurrence of instability happened in anyone of them,whereas considerable subjective improvement in ankle instability were reported in all patients.[Conclusion]This arthroscopic anterior talofibular ligament repair with a knotless suture anchor does achieve satisfactory clinical outcomes with benefits of high safety and reliability for chronic ankle lateral instability.

关 键 词：踝关节不稳定 距腓前韧带 关节镜术 韧带修复 无结锚钉 

分 类 号：R683.5[医药卫生—骨科学]