可吸收免打结线带重建治疗军事训练致慢性踝关节不稳的效果观察  

Observation on the therapeutic effects of absorbable knot free band reconstruction in treatment of chronic ankle instability caused by military training

作　　者：高成云 张志凌 尚旭亚 Gao Chengyun;Zhang Zhiling;Shang Xuya(Department of Joint Trauma Orthopedics,Second Naval Hospital of Southern Theater Command,Sanya 572000,China)

机构地区：[1]南部战区海军第二医院关节创伤骨科,海南三亚572000

出　　处：《海军医学杂志》2023年第7期675-679,共5页Journal of Navy Medicine

基　　金：海南省卫生计生行业科研项目(19A200087)。

摘　　要：目的探究距腓前韧带(anterior talofibular ligament,ATFL)锚钉修复与可吸收免打结线带(Internal Brace)重建治疗军事训练致慢性踝关节不稳(chronic ankle instability,CAI)患者的临床疗效及安全性。方法前瞻性选取南部战区海军第二医院关节创伤骨科2017年5月至2022年5月收治的120例军事训练致CAI患者作为研究对象,采用简单随机分组中掷硬币法分为A组(64例)、B组(56例),A组患者采用Internal Brace重建治疗,B组患者采用锚钉修复治疗。比较2组患者手术相关指标(手术用时、术中出血量、术后恢复正常生活用时),比较2组患者治疗前、治疗6个月后踝关节活动度(踝关节距骨倾斜角、跖屈角度、背伸角度、内翻角度、外翻角度、距骨前移距离)、美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)评分、Tegner活动水平评分、视觉模拟评分(visual analogue scale,VAS)情况,观察2组患者不良反应发生情况。结果(1)A组患者术后恢复正常生活用时显著少于B组,差异有统计学意义(P<0.05);(2)治疗6个月后,2组患者踝关节距骨倾斜角、内翻角度、外翻角度、距骨前移距离均下降且A组小于B组,跖屈角度均上升且A组大于B组,背伸角度均下降且A组大于B组,差异均有统计学意义(P<0.05);(3)治疗6个月后,2组患者AOFAS、Tegner评分均上升且A组高于B组,VAS评分均下降且A组低于B组,差异均有统计学意义(P<0.05)。结论军事训练致CAI患者采用Internal Brace重建治疗效果理想,能够有效改善患者踝关节活动度、踝关节功能,降低疼痛水平,促进患者术后恢复且手术安全性较好,值得临床参考借鉴。Objective To explore the clinical efficacy and safety of anterior talofibular ligament anchor repair and absorbable knot free suture reconstruction in treatment of chronic ankle instability(CAI)caused by military training.Methods 120 patients with CAI caused by military training who were admitted to the Joint Trauma Orthopedics Department of the Second Naval Hospital in the Southern Theatre Command from May 2017 to May 2022 were recruited as research subjects,and were randomly divided into group A(n=64)and group B(n=56).The patients in Group A were treated with internal brace reconstruction,while the patients in Group B received anchor repair.Related surgical indexes(such as operation time,intraoperative blood loss,time to return to normal life after surgery),the joint mobility(ankle talus tilt angle,plantar flexion angle,dorsal extension angle,varus angle,valgus angle,talus forward distance)before treatment and 6 months after treatment,the American Orthopedic Foot and Ankle Society(AOFAS)scores,Tegner activity level scores,as well as the visual analog scale(VAS)scores were compared between the 2 group,at the same time,the adverse reactions of the two groups were also compared between the 2 groups.Results(1)The time to return to normal life activity after surgery in the patients of Group A was significantly shorter than that in the patients of Group B,with statistical significance(P<0.05).(2)Six months after treatment,the inclination angle of the ankle talus,the varus angle,the eversion angle and the forward distance of the talus in both groups decreased,with the indicators of Group A being lower than those of Group B.The plantar flexion angle in both groups all increased,with the angle of Group A being higher than that of Group B.The dorsi extension angle in both groups all decreased,with the extension angle of Group A being higher than that of Group B,with statistical significance(P<0.05).(3)After 6 months of treatment,AOFAS and Tegner scores in both groups all increased,with group A being higher than those of

关 键 词：距腓前韧带 锚钉修复 可吸收免打结线带重建 慢性踝关节不稳 军事训练 

分 类 号：R684[医药卫生—骨科学]