缝合锚钉经内踝修复三角韧带深层损伤  

Suture anchor and medial malleolus repair in treatment of injury in the deep layer of deltoid ligament

作　　者：孔长庚[1] 郭祥[1] 吴多庆[1] 黄友华[1] 王琮仁 符惠斯 范忠诚 陈波 沈慧 Kong Changgeng;Guo Xiang;Wu Duoqing;Huang Youhua;Wang Congren;Fu Huisi;Fan Zhongcheng;Chen Bo;Shen Hui(Department of Orthopedics,Affiliated Haikou Hospital,Xiangya School of Medicine,Central South University,Haikou 570208,Hainan Province,China;Department of Orthopedics,Haikou Orthopedics and Diabetes Hospital,Haikou 570311,Hainan Province,China)

机构地区：[1]中南大学湘雅医学院附属海口医院骨科,海南省海口市570208 [2]海口市骨科与糖尿病医院骨科,海南省海口市570311

出　　处：《中国组织工程研究》2025年第15期3193-3198,共6页Chinese Journal of Tissue Engineering Research

基　　金：海南省卫生健康行业科研项目(20A200103),项目负责人:孔长庚。

摘　　要：背景:踝关节骨折合并三角韧带损伤在临床上较为常见,骨折内固定一期修复三角韧带逐渐成为主流治疗方法,明显降低了踝关节远期并发症的发生。近年来在三角韧带解剖结构特征和动态生物力学研究领域取得新进展,使三角韧带深层损伤修复技术有了较大提高,但仍存在争议。目的:探讨缝合锚钉技术与经内踝修复踝关节骨折合并三角韧带深层损伤的临床疗效。方法:选择中南大学湘雅医学院附属海口医院2017年1月至2022年1月收治的踝关节骨折合并三角韧带深浅层完全断裂的56例患者,依据带线锚钉修复三角韧带深层的方式不同分为2组,其中缝合锚钉修复组32例,经内踝修复组24例。对两组患者手术治疗前后的踝关节内侧间隙、美国矫形外科足踝协会评分进行评定。结果与结论:①56例患者均顺利完成手术并获得术后12个月以上随访,踝部骨折均愈合,骨折愈合时间8-12周,平均10.5周;②两组患者术后12个月踝关节内侧间隙较术前显著缩小,差异有显著性意义(P<0.001);术后12个月,两组踝关节内侧间隙维持在正常范围,组间对比差异无显著性意义(P>0.05);③术后6,12个月,两组患者美国矫形外科足踝协会评分较术前显著升高(P<0.001),相应时间点,两组美国矫形外科足踝协会评分相比差异均无显著性意义(P>0.05);④提示缝合锚钉技术与经内踝修复三角韧带深层损伤均能恢复踝关节内侧间隙、有效维持踝穴的稳定性,获得良好的临床疗效。BACKGROUND:Ankle fracture complicated with deltoid ligament injury is clinically common,and one stage repair of deltoid ligament with internal fracture fixation has gradually become a main therapeutic method,which can significantly reduce the long-term complications of ankle joint.In recent years,new progress has been made in anatomical structure characteristics and dynamic biomechanical research of deltoid ligament,thus greatly improving repairing techniques for injury in the deep layer of deltoid ligament,but there are still some controversies.OBJECTIVE:To explore the clinical efficacy of suture anchor and medial malleolus repair in the treatment of ankle joint fractures with the deep layer of deltoid ligament.METHODS:A total of 56 patients with ankle joint fractures and complete fracture of the deep and superficial layer of deltoid ligament treated in Affiliated Haikou Hospital,Xiangya School of Medicine,Central South University from January 2017 to January 2022 were selected,and they were divided into two groups according to different treatment methods in repairing the deep layer of deltoid ligament with suture anchor:suture anchor repair group(n=32)and medial malleolus repair group(n=24).The medial clear space of ankle joint and American Orthopedic Foot and Ankle Society Score of patients in the two groups were evaluated before and after operative treatment.RESULTS AND CONCLUSION:(1)All the 56 patients finished the surgery smoothly and were followed up for more than 12 months after operation.Their ankle fracture healed,and the time for fracture healing was 8-12 weeks,with a mean of 10.5 weeks.(2)The medial clear space of ankle joint in the two groups 12 months after operation was remarkably narrower than that before operation,and the difference was statistically significant(P<0.001).The medial clear space of ankle joint in the two groups maintained a normal range 12 months after operation,and there was no statistically significant difference between the two groups(P>0.05).(3)The AOFAS scale of patients in th

关 键 词：踝关节骨折 三角韧带 缝合锚钉 经内踝修复 踝关节内侧间隙 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687