不同手术治疗对距骨骨软骨损伤合并踝关节外侧不稳的影像对比及疗效分析  

Different Surgical Treatment of Talus Bone Cartilage Injury Combined Ankle Lateral Instability of the Image Contrast and Curative Effect Analysis

作　　者：朱鹏飞[1] 刘玉杰 张万喜 高岩[1] ZHU Pengfei;LIU Yujie;ZHANG Wanxi;GAO Yan(Department of Orthopedics,The Second Hospital of Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院骨科,河北063000

出　　处：《影像科学与光化学》2025年第2期112-120,127,共10页Imaging Science and Photochemistry

摘　　要：目的:探讨关节镜下外侧韧带止点修复重建术相比传统韧带修复手术在治疗距骨骨软骨损伤合并踝关节外侧不稳中的疗效差异。方法:选取2020年6月至2022年6月期间在我院就诊的100例距骨骨软骨损伤合并踝关节外侧不稳患者,随机分为研究组和对照组,各50例。所有患者均接受微骨折手术,研究组在此基础上增加关节镜下外侧韧带止点修复重建术,对照组则采用韧带修复手术。通过影像观察和临床评分评估治疗效果。结果:治疗后,研究组患者的AOFAS评分为(95.23±5.72)分,Tegner评分为(5.54±1.85)分,JSSF评分为(97.12±5.65)分,均显著高于对照组(P<0.05)。同时,研究组的VAS评分为(1.85±0.66)分,距骨倾斜角为2.56°±0.52°,距骨前移为(2.84±0.48)mm,均显著低于对照组(P<0.05)。研究组的效益⁃风险总值为69分,显著高于对照组的53分,表明在疗效和风险综合考量上研究组全面优于对照组。结论:本研究表明,关节镜下外侧韧带止点修复重建术在治疗距骨骨软骨损伤合并踝关节外侧不稳中疗效显著优于传统韧带修复手术,且具有更低的风险,值得在临床实践中推广应用。Objective:To investigate the efficacy of arthroscopic lateral ligament repair and reconstruction compared with traditional ligament repair in the treatment of talus osteochondral injury combined with lateral ankle instability.Methods:A total of 100 patients with talus osteochondral injury combined with lateral ankle instability treated in our hospital from June 2020 to June 2022 were randomly divided into a study group and a control group,with 50 cases in each group.All patients received micro fracture surgery,and arthroscopie lateral ligament insertion repair and reconstruction was added to the study group,while the control group adopts the surgery to repair ligament.The therapeutic effect was evaluated by imaging observation and clinical score.Results:After treatment,the AOFAS score for the study group was(95.23±5.72)points,the Tegner score was(5.54±1.85)points,and the JSSF score was(97.12±5.65)points,which were all significantly higher than the control group(P<0.05).At the same time,the VAS score for the study group was(1.85±0.66)points,the inclination angle of the talus was 2.56°±0.52°,and the anterior displacement of the talus was(2.84±0.48)mm,which were all significantly lower than the control group(P<0.05).The total benefit⁃risk value for the study group was 69 points,which was significantly higher than the 53 points for the control group,indicating that the study group was comprehensively superior to the control group in terms of effectiveness and risk.Conclusion:This study shows that the lateral ligament under arthroscopy check point repair revascularization in treatment of talus bone cartilage injury combined lateral ankle instability in curative effect significantly better than traditional surgery to repair ligament,and has a lower risk,is worthy of popularization and application in clinical practice.

关 键 词：外侧韧带止点修复重建术 距骨骨软骨损伤 踝关节外侧不稳 

分 类 号：R684[医药卫生—骨科学]