距腓前韧带损伤临床流行病学分析  

Clinical Epidemiological Analysis of Anterior Talofibular Ligament Injuries

作　　者：郑果 杨钱冬 王震宇 王云蛟 唐康来 陶旭 Zheng Guo;Yang Qiandong;Wang Zhenyu;Wang Yunjiao;Tang Kanglai;Tao Xu(Sports Medicine Center,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院运动医学中心,重庆400038

出　　处：《实用骨科杂志》2022年第8期696-701,共6页Journal of Practical Orthopaedics

摘　　要：目的研究距腓前韧带损伤的临床特点及其流行病学情况。方法回顾性分析2007年7月至2020年12月陆军军医大学第一附属医院运动医学中心诊断为距腓前韧带损伤360例患者资料,其中男231例,女129例;年龄8~86岁,平均(30.6±13.3)岁;左踝149例,右踝211例。距腓前韧带止点撕脱骨折177例,其中腓骨侧168例,距骨侧9例;实质部损伤183例。受伤至就诊时间0~365个月,平均(20.7±44.5)个月。将病例按损伤类型分组,对受伤原因、受伤至就诊时间、性别、侧别、年龄、合并损伤等因素进行分析,同时比较不同类型距腓前韧带损伤的个体化因素及合并损伤情况。结果距腓前韧带损伤患者男性(231例)占64.2%,18~40岁是发病高峰(66.4%),患者多于伤后1个月内就诊(32.8%);受伤原因以扭伤为主(51.1%),其次为运动伤(32.8%);合并及并发损伤中所占比率分别为:距骨软骨及骨损伤(23.1%)、慢性踝关节不稳(20.3%)、踝关节撞击(16.4%)、跟腓韧带(11.4%)、创伤性关节炎(9.2%);距腓前韧带实质部损伤(50.8%)与止点撕脱骨折(49.2%)发生率相近,但发生合并及并发损伤的概率较后者高(P<0.05),患者年龄结构差异有统计学意义(P<0.05)。结论距腓前韧带损伤止点撕脱骨折与实质部损伤发病率没有明显差异,实质部损伤合并及并发损伤率较高(58.6%),以距骨软骨损伤(23.1%)及慢性踝关节不稳(20.3%)损伤最为常见;止点撕脱骨折以腓骨侧为主(94.9%),合并及并发损伤较少(41.4%)。Objective To study the clinical characteristics and epidemiology of anterior talofibular ligament(ATFL)injuries.Methods The 360 inpatients with ATFL injury from July 2007 to December 2020 in Sports Medicine Center of the First Affiliated Hospital of Army Medical University were retrospectively analyzed.Among them,there were 231 males and 129 females.149 left ankles and 211 right ankles were included.The ages ranged from 8 to 86 years,with a mean of(30.6±13.3)years.There were 177 avulsion fractures of the ATFL insertion(including 168 cases on the fibular side and 9 cases on the talar side),and there were 183 midsubstance injuries.The time from the injury to treatment ranged from 0 to 365 months,with an average of(20.7±44.5)months.The patients were divided into groups according to the injuries types,and the factors such as injuries cause,time from injuries to treatment,gender,side,age and combined injuries were analyzed.At the same time,the individual factors and combined injuries of different types of ATFL injuries were compared.Results Male patients(231 cases)with ATFL injuries accounted for 64.2%.The peak of incidence was from 18 to 40 years old(66.4%).The number of patients who visited the hospital within one month after injuries was more than 32.8%.The main cause of injuries was sprain(51.1%),followed by sports injuries(32.8%).The combined and concurrent injuries included talar cartilage and bone injuries(23.1%),chronic ankle instability(20.3%),ankle impingement syndrome(16.4%),followed by calcaneofibular ligament injuries(11.4%)and traumatic arthritis(9.2%).The incidence of ATFL in-substance injuries(50.8%)and insertion avulsion fracture(49.2%)were similar,but the probability of combined and concurrent injuries were higher than that of the latter(P<0.05),and the difference of age structure had statistical significance(P<0.05).Conclusion The incidence rate of avulsion fracture and in-substance injuries are not significantly different.The rate of injuries of the in-substance Complications injuries is higher(5

关 键 词：距腓前韧带 损伤 流行病学 

分 类 号：R686.5[医药卫生—骨科学]