关节镜下与开放式Broström-Gould术修复距腓前韧带治疗青年男性高强度运动人群慢性踝关节不稳的疗效比较  

Arthroscopic versus open Broström-Gould repair of the anterior talofibular ligament for chronic ankle instability in young men undergoing high intensity exercise

作　　者：古浩然 籍婧睿 吕江宏 伊永东 周辉[1] 李涛 Gu Haoran;Ji Jingrui;Lyu Jianghong;Yi Yongdong;Zhou Hui;Li Tao(Department of Trauma and Orthopedics,947th Army Hospital of Chinese People's Liberation Army,Xinjiang Uygur Autonomous Region,Kashgar 844000,China;Health Company,Service Support Battalion,Unit 77123,Chinese People's Liberation Army,Mianyang 621000,China;Department of Orthiopaedics and Trauma,Center for Orthopedic Surgery,The Third Affiliated Hospital,Southern Medical University,Guangzhou 510630,China)

机构地区：[1]中国人民解放军陆军第九四七医院创伤骨科,喀什844000 [2]中国人民解放军第77123部队勤务保障营卫生连,绵阳621000 [3]南方医科大学第三附属医院骨科医学中心创伤骨科,广州510630

出　　处：《中华创伤骨科杂志》2025年第2期175-179,共5页Chinese Journal of Orthopaedic Trauma

基　　金：广东援疆农村科技(特派员)项目(KTPYJ2023003)。

摘　　要：目的比较关节镜下与开放式Broström-Gould术修复距腓前韧带(ATFL)治疗青年男性高强度运动人群慢性踝关节不稳定(CAI)的疗效。方法回顾性分析2016年1月至2020年7月中国人民解放军陆军第九四七医院创伤骨科收治的61例青年男性高强度运动CAI患者。年龄(25.9±2.7)岁,病程(13.9±2.8)个月。根据治疗方法不同分为关节镜组(26例,关节镜下修复ATFL)和Broström-Gould组(35例,开放式Broström-Gould术修复ATFL)。比较两组患者的手术时间、术中出血量,以及术后3、6、12、24个月的美国足踝外科协会(AOFAS)踝-后足评分、卡尔森踝关节功能(KAF)评分、疼痛视觉模拟评分(VAS)。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。关节镜组患者术中手术时间[(35.8±3.9)min]、术中出血量[(6.6±2.6)mL]均显著少于Broström-Gould组患者[(52.1±4.6)min、(16.1±4.0)mL],差异均有统计学意义(P<0.05)。关节镜组患者术后3、6个月的AOFAS踝-后足评分、KAF评分均显著高于Broström-Gould组患者,术后24个月的AOFAS踝-后足评分、KAF评分显著低于Broström-Gould组患者,差异均有统计学意义(P<0.05);术后12个月两组患者间AOFAS踝-后足评分、KAF评分比较,以及术后3、6、12、24个月疼痛VAS评分比较差异均无统计学意义(P>0.05)。结论对于青年男性高强度运动CAI患者,关节镜下修复ATFL后短期(术后3个月)即见明显疗效,且踝关节运动功能恢复情况优于开放式Broström-Gould术修复ATFL,但后者的长期疗效(术后24个月)优于前者。ObjectiveTo compare arthroscopic versus open Broström-Gould repair of the anterior talofibular ligament(ATFL)in the treatment of chronic ankle instability(CAI)in young men undergoing high intensity exercise.MethodsA retrospective study was conducted to analyze the 61 young male patients with CAI undergoing high-intensity exercise who had been treated at Department of Trauma and Orthopedics,947th Army Hospital of Chinese People’s Liberation Army from January 2016 to July 2020.Their age was(25.9±2.7)years and their disease duration(13.9±2.8)months.According to their different treatment methods,they were divided into an arthroscopic group(n=26)in which their ATFL was repaired by arthroscopic Broström-Gould surgery and a Broström-Gould group(n=35)in which their ATFL was repaired by open Broström-Gould surgery.The 2 groups were compared in terms of operation time and intraoperative bleeding,as well as the ankle-hindfoot scores of American Orthopaedic Foot&Ankle Society(AOFAS),Karlsson ankle functional(KAF)scores and visual analogue scale(VAS)pain scores at postoperative 3,6,12,and 24 months.ResultsThere were no significant differences in the preoperative general data between the 2 groups,indicating comparability(P>0.05).The operation time[(35.8±3.9)min]and intraoperative bleeding[(6.6±2.6)mL]in the arthroscopic group were significantly less than those in the Broström-Gould group[(52.1±4.6)min and(16.1±4.0)mL](P<0.05).The AOFAS ankle-hindfoot scores and KAF scores in the arthroscopic group were significantly higher than those in the Broström-Gould group at postoperative 3 and 6 months,but the AOFAS ankle-hindfoot score and KAF score at postoperative 24 months were significantly lower than those in the Broström-Gould group(P<0.05).There was no statistically significant difference in AOFAS ankle-hindfoot score or KAF score between the 2 groups at postoperative 12 months,as well as in VAS pain scores at postoperative 3,6,12,and 24 months between the 2 groups(P>0.05).ConclusionsIn young men undergoing high i

关 键 词：关节镜 外科手术 踝关节 修复 

分 类 号：R687.4[医药卫生—骨科学]