Brostrom-Gould修复术联合Internal Brace加强治疗慢性踝关节外侧不稳定的临床疗效  

Clinical efficacy of Brostrom-Gould procedure combined with Internal Brace augmentation in the treatment of chronic lateral ankle instability

作　　者：张琳袁 吴佳俊 崔崟 付备刚 蔡攀 贾永伟 沈超 ZHANG Linyuan;WU Jiajun;CUI Yin;FU Beigang;CAI Pan;JIA Yongwei;SHEN Chao(Department of Orthopaedics,Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital,Shanghai 201318,China)

机构地区：[1]上海健康医学院附属周浦医院骨科,上海201318

出　　处：《中华骨与关节外科杂志》2024年第4期321-325,共5页Chinese Journal of Bone and Joint Surgery

基　　金：浦东新区卫生健康委员会卫生计生科研项目(PW2022A-42)。

摘　　要：目的:探讨Brostrom⁃Gould修复术联合Internal Brace加强治疗慢性踝关节外侧不稳定(CLAI)的临床疗效。方法:回顾性分析2018年3月至2022年12月行Brostrom⁃Gould修复术联合Internal Brace加强治疗的32例CLAI患者的临床资料。其中男19例,女13例,年龄36(29,41)岁(23~56岁);运动损伤13例,日常扭伤15例,交通事故等其他损伤4例。记录术前及末次随访时美国足踝外科协会(AOFAS)踝-后足评分及踝关节Kofoed评分以评估踝关节功能,并记录疼痛视觉模拟评分(VAS),同时观察并发症发生情况。结果:所有患者均顺利完成手术,切口均一期愈合,术后1例患者出现腓浅神经损伤。所有患者均获得随访,随访时间17(14,18)个月(12~38个月)。末次随访时患者AOFAS踝-后足评分由术前的(68.4±10.4)分增加至(92.2±11.2)分;踝关节Kofoed评分由术前的(64.6±14.1)分增加至(90.0±7.9)分,疼痛VAS评分由术前的3.2(2.5,3.6)分降低至0.8(0.5,1.0)分,且差异均有统计学意义(P均<0.05)。1例患者术后6个月出现踝关节外侧紧缚感,经功能锻炼后好转。结论:Brostrom⁃Gould修复术联合Internal Brace加强治疗CLAI,提供了可靠的即刻稳定性,并发症发生率低,有利于患者早期功能锻炼,尽快恢复负重行走及日常生活。Objective:To explore the clinical efficacy of Brostrom-Gould procedure combined with Internal Brace augmentation in the treatment of chronic lateral ankle instability(CLAI).Methods:From March 2018 to December 2022,data from 32 CLAI patients,including 19 males and 13 females,aged 23-56 years with the median age of 36(29,41)years,who underwent Brostrom-Gould combined with Internal Brace reconstruction of the anterior talofibular ligament were retrospectively analyzed.There were 13 sports injuries,15 flat sprains and 4 traffic injuries.The American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot scores and Kofoed scores before the operation and the last follow-up were recorded to evaluate ankle joint function.The visual analogue scale(VAS)score of pain was also recorded.Additionally,the occurrence of complications was observed.Results:All surgeries were operated smoothly,with wound healing occurring in one stage after the operation.However,one patient experienced superficial peroneal nerve injury.Patients were followed up for 12-38 months,with the median of 17(14,18)months.At the last follow-up,the AOFAS score increased from(68.4±10.4)to(92.2±11.2)points,and the Kofoed score increased from(64.6±14.1)to(90.0±7.9)points.The VAS pain score decreased from 3.2(2.5,3.6)to 0.8(0.5,1.0)points.These improvements were statistically significant(all P<0.05).One patient experienced a sensation of lateral ankle tightness six months postoperatively,which resolved after functional exercises.Conclusions:The combination of Brostrom-Gould procedure with Internal Brace augmentation provides reliable immediate stability for the treatment of CLAI,with a low incidence of complications,facilitating early functional rehabilitation for patients to resume weight-bearing and daily activities promptly.

关 键 词：慢性踝关节外侧不稳定 Brostrom-Gould修复术 Internal Brace 

分 类 号：R684.7[医药卫生—骨科学]