改良Karlsson术治疗踝关节外侧副韧带慢性损伤的疗效分析  

Analysis of curative effect of anatomic repair technique in the treatment of chronic injury of lateral collateral ligament of ankle joint

作　　者：马滚韶[1] 徐勤[1] 罗裕强 黄远翘[1] 莫华贵[1] Ma Gunshao;Xu Qin;Luo Yuqiang;Huang Yuanqiao;Mo Huagui(Department of Orthopedics of Joints of Limbs,the Central Hospital of Jiangmen City,Guangdong Jiangmen 529030)

机构地区：[1]江门市中心医院四肢关节骨科,广东江门529030

出　　处：《中国社区医师》2020年第34期18-19,共2页Chinese Community Doctors

摘　　要：目的:探讨改良Karlsson术治疗踝关节外侧副韧带慢性损伤的有效性及安全性。方法:2016年6月-2019年6月收治踝关节外侧副韧带慢性损伤患者18例,应用改良Karlsson术结合踝关节镜清理治疗。结果:18例患者切口愈合良好,未出现切口并发症;无1例患者出现锚钉骨道骨折、下肢深静脉血栓等;1例患者再次出现踝关节扭伤,予以石膏固定后痊愈。所有患者最后1次随访时,前抽屉试验及距骨倾斜试验均为阴性。本组病例术后距骨倾斜角减少平均(2.9±0.4)°,与术前比较差异有统计学意义(P<0.01)。距骨前移量减少为平均(2.7±1.7)mm,与术前比较差异有统计学意义(P<0.05);最后1次随访时,AOFAS评分比术前明显提高,差异有统计学意义(P<0.01)。18例患者术后优10例,良5例,一般2例,差1例,优良率为83.3%。结论:改良Karlsson术治疗踝关节外侧副韧带慢性损伤疗效确切,安全性好,如有条件术中可同期进行踝关节镜检查,以进一步明确损伤细节、提高疗效。Objective:To investigate the effectiveness and safety of anatomical repair technique(modified Karlsson procedure)in the treatment of chronic injury of lateral collateral ligament of ankle joint.Methods:From June 2016 to June 2019,18 patients with chronic injury of lateral collateral ligament of ankle joint were selected and treated with modified Karlsson procedure combined with ankle arthroscopic debridement.Results:All patients'incisions healed well without incision complications.None of the patients had fracture of bone canal of anchor nail and deep vein thrombosis of the lower extremity.One patient suffered from ankle sprain again and recovered after plaster fixation.At the last follow-up,all patients had negative anterior drawer test and talus tilt test.The average angle of talus after operation decreased by(2.9±0.4)°,the difference was statistically significant(P<0.01).The average forward displacement of talus was(2.7±1.7)mm,the difference was statistically significant(P<0.05).At the last follow-up,the AOFAS score was significantly higher than that before operation,the difference was statistically significant(P<0.01).After operation,there were excellent in 10 cases,good in 5 cases,fair in 2 cases,poor in 1 case,the excellent and good rate was 83.3%.Conclusion:The modified Karlsson procedure is effective and safe in the treatment of chronic injury of lateral collateral ligament of ankle joint,if possible,ankle arthroscopy can be performed simultaneously to further clarify the details of injury and improve the curative effect.

关 键 词：解剖修复 Karlsson术 踝关节外侧副韧带慢性损伤 

分 类 号：R687.4[医药卫生—骨科学]