关节镜下韧带增强固定与改良Brostrom术对慢性踝关节外侧不稳定患者踝关节功能的影响  

Comparison of the effects of an arthroscopic ligament augmentation and fixation and a modified Brostrom operation on the ankle function in patients with chronic lateral ankle instability

作　　者：赵廷虎 李彦 ZHAO Tinghu;LI Yan(Foot and Ankle Surgery Department,Shenzhen Orthopedics Hospital/Shenzhen Pingshan Hospital of Traditional Chinese Medicine,Shenzhen 518010,China;Trauma Department,Shenzhen Orthopedics Hospital/Shenzhen Pingshan Hospital of Traditional Chinese Medicine,Shenzhen 518010,China)

机构地区：[1]深圳市骨伤科医院/深圳市坪山区中医院足踝外科,广东深圳518010 [2]深圳市骨伤科医院/深圳市坪山区中医院创伤科,广东深圳518010

出　　处：《长春中医药大学学报》2023年第2期192-196,共5页Journal of Changchun University of Chinese Medicine

基　　金：广东省中医药局科研项目(20211353)。

摘　　要：目的 对比关节镜下韧带增强固定与改良Brostrom术对慢性踝关节外侧不稳定患者踝关节功能的影响。方法 选择慢性踝关节外侧不稳定患者80例,按随机数表法分为改良Brostrom术组、关节镜下韧带增强固定组,各40例。改良Brostrom术组给予改良Brostrom术治疗,关节镜下韧带增强固定组给予关节镜下韧带增强固定治疗,2组术后均随访1年。比较2组围手术期指标,术前、术后1年踝关节影像学指标,多时间点足与踝功能(FAAM)、美国矫形外科足踝协会(AOFAS)踝与后足功能评分,随访1年切口愈合、复发情况。结果 关节镜下韧带增强固定组术中出血量低于改良Brostrom术组,术后下床时间、手术时间、恢复正常生活时间短于改良Brostrom术组(P <0.05)。术后1年,2组距骨倾斜角、距骨前移距离较术前降低,且关节镜下韧带增强固定组低于改良Brostrom术组(P <0.05)。与术前比较,2组术后6个月、术后1年FAAM(日常运动、体育运动)、AOFAS踝与后足功能评分均呈升高趋势,且术后6个月、术后1年关节镜下韧带增强固定组FAAM(日常运动、体育运动)、AOFAS踝与后足功能评分高于改良Brostrom术组(P <0.05)。随访1年,2组甲级愈合、乙级愈合比例比较,差异无统计学意义(P> 0.05),关节镜下韧带增强固定组复发率低于改良Brostrom术组(P <0.05)。结论 与改良Brostrom术比较,关节镜下韧带增强固定治疗慢性踝关节外侧不稳定可改善患者围手术期指标,促进踝关节功能恢复,优化踝关节影像学指标,降低复发风险。Objective To compare the effects of an arthroscopic ligament augmentation and fixation and a modified Brostrom operation on the ankle function in patients with chronic lateral ankle instability. Methods A total of 80 patients with chronic lateral ankle instability treated in our hospital from January 2019 to January 2021 were divided into a modified Brostrom operation group and an arthroscopic ligament augmentation and fixation group by the random number table method, with 40 cases in each group. The modified Brostrom operation group was treated with modified Brostrom operations, while the arthroscopic ligament augmentation and fixation group was treated with the arthroscopic ligament augmentation and fixation. Both groups were followed up for one year after operation. The perioperative indexes, ankle imaging indexes before operation and after one year of operation,the scores of the Foot and Ankle Ability Measure(FAAM) and the ankle and hindfoot function by the American Orthopedic Foot and Ankle Society(AOFAS) at dif ferent time points, and the wound healing and recurrence after one-year follow-up were compared between the two groups. Results The intraoperative blood loss in the arthroscopic ligament augmentation and fixation group was lower than that in the modified Brostrom operation group, and the postoperative ambulation time, operation time,and the time to return to normal life were shorter than those in the modified Brostrom operation group(P<0.05). One year after operation, the talus inclination angle and the talus anterior displacement in the two groups were lower than those before operation,and the arthroscopic ligament augmentation and fi xation group was lower than the modified Brostrom operation group(P<0.05).Six months and one year after operation, the scores of FAAM(daily exercise, sports) and the AOFAS ankle and hindfoot function were increased in both groups, and the scores in the arthroscopic ligament augmentation and fi xation group were higher than those in the modifi ed Brostrom operation grou

关 键 词：慢性踝关节外侧不稳定 关节镜下韧带增强固定 改良Brostrom术 踝关节功能 踝关节影像学指标 

分 类 号：R687.4[医药卫生—骨科学]