慢性踝关节外侧不稳合并距骨骨软骨损伤的韧带及距骨软骨MRI评估分析  

Relevant MRI assessment of chronic lateral ankle instability with talar osteochondral injury

作　　者：但倩 陈玥 李兰[1] DAN Qian;CHEN Yue;LI Lan(Department of medical imaging,Sichuan orthopedic hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院医学影像科,四川成都610041

出　　处：《医学影像学杂志》2024年第10期129-133,共5页Journal of Medical Imaging

基　　金：四川省干部保健科研课题项目(编号:川干研2021-608)。

摘　　要：目的探讨分析慢性踝关节外侧不稳合并距骨骨软骨损伤的MRI表现特点、伴随韧带损伤情况,为临床治疗方法的选择提供有利的影像学诊断依据。方法选取我院临床诊断为慢性踝关节不稳合并距骨骨软骨损伤的患者46例作为观察组,仅距骨骨软骨损伤患者45例作为对照组,将距骨圆顶分为6个区域,并记录距骨骨软骨损伤位置及MRI分期。统计观察组外侧韧带及胫腓下联合韧带损伤情况。结果观察组韧带损伤中距腓前韧带合并跟腓韧带损伤发生率最高,为50.0%;胫腓下联合损伤36例,发生率为78.3%。两组距骨软骨损伤位置情况,对照组内侧穹隆发生率最高,约86.0%;观察组距骨内、外侧穹隆软骨损伤发生率为内侧49.3%、外侧50.7%,差异无统计学意义(P>0.05)。两组距骨骨软骨损伤分期:观察组较对照组距骨软骨损伤分期更低。结论慢性踝关节外侧不稳合并距骨骨软骨损伤患者除了关注踝关节外侧韧带损伤,还需关注胫腓前下联合韧带情况,详细了解踝关节几何结构变化,对临床制定诊疗计划及术后评价提供有利影像学依据。Objective To analyze the characteristics of MRI findings and concomitant ligamentous injuries in patients with chronic lateral ankle instability and talar osteochondral injuries,and to provide a favorable diagnostic basis for the clinical selection of appropriate treatment options.Methods Forty-six patients diagnosed with chronic ankle instability and talar osteochondral injury were selected as the observation group in our hospital.In comparison,45 patients with talar osteochondral injury alone were chosen as the control group.The talar dome was divided into six regions,and the location and MRI stage of the talar osteochondral injury were meticulously recorded.The statistical analysis focused on the injury of the lateral ligament and the combined tibiofibular ligament in the observation group.Results Ligament injuries were observed in the observation group:the anterior fibular ligament combined with the heel fibular ligament injury had the highest incidence,approximately 50.0%;There were 36 cases of combined tibiofibular injury,with an incidence of approximately 78.3%.The location of talar cartilage injury was the case in both groups,with the highest incidence of medial dome in the control group at approximately 86.0%;The incidence of chondral injury in the internal and external dome of the talus in the observation group was 49.3%medially and 50.7%laterally,but this difference was not statistically significant.As talar osteochondral staging in two groups,the observation group had a lower talar cartilage injury stage than the control group.Conclusions In addition to focusing on lateral ankle ligament injuries,for patients with chronic lateral ankle instability and talar osteochondral injuries,doctors should also pay attention to the anterior inferior tibiofibular joint ligament situation,understand the ankle geometry changes in detail,and provide a favorable imaging basis for developing a diagnosis and treatment plan and postoperative evaluation.

关 键 词：慢性踝关节外侧不稳 距骨骨软骨损伤 磁共振成像 

分 类 号：R684.7[医药卫生—骨科学] R445.2[医药卫生—外科学]