[1]张思远,林武杰,郭文煊,等.同种异体肌腱微创解剖重建踝关节外侧韧带治疗慢性踝关节外侧不稳[J].中医正骨,2022,34(08):69-72.
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同种异体肌腱微创解剖重建踝关节外侧韧带治疗慢性踝关节外侧不稳()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年08期
页码:
69-72
栏目:
临床报道
出版日期:
2022-08-20

文章信息/Info

作者:
张思远1; 林武杰2; 郭文煊1; 吴向科3; 庄汝杰4
(1.浙江中医药大学第一临床医学院,浙江 杭州 310053; 2.台州市黄岩区中医院,浙江 台州 318020; 3.浙江中医药大学附属四省边际中医院,浙江 衢州 324002; 4.浙江省中医院,浙江 杭州 310006)
关键词:
外侧韧带; 踝;  慢性踝关节外侧不稳;  同种异体肌腱移植;  步态分析
摘要:
目的:观察同种异体肌腱微创解剖重建踝关节外侧韧带治疗慢性踝关节外侧不稳的临床疗效。方法:2019年3月至2021年3月收治32例慢性踝关节外侧不稳患者。男14例,女18例。年龄21～68岁,中位数41岁。左侧17例,右侧15例。踝关节MRI检查显示,所有患者均存在距腓前韧带断裂,其中3例合并跟腓韧带损伤。病程7～18个月,中位数12个月。均先在关节镜下探查清理,然后根据踝关节外侧韧带损伤情况,以同种异体肌腱单独重建距腓前韧带或同时重建距腓前韧带和跟腓韧带。采用视觉模拟量表(visual analogue scale,VAS)评价踝关节疼痛情况,采用美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足评分量表和三维步态分析系统评价踝关节功能,三维步态分析系统测定的指标包括垂直地反力峰值、单支撑相百分比及踝关节最大背伸角度。结果:患者均顺利完成手术。所有患者均获随访,随访时间3～12个月,中位数6个月。切口均甲级愈合。术后3个月时,患者的踝关节疼痛VAS评分较术前降低[(4.50±0.73)分,(0.50±0.64)分,t=43.181,P=0.000],AOFAS踝与后足评分、垂直地反力峰值、单支撑相百分比及踝关节最大背伸角度均较术前增大[(63.62±2.2)分,(94.09±1.69)分,t=-55.971,P=0.000;(1.13±0.06)N·kg-1,(1.26±0.05)N·kg-1,t=-20.238,P=0.000;(34.79±1.17)%,(39.76±1.37)%,t=-24.637,P=0.000; 11.30°±1.03°,13.91°±1.43°,t=-20.678,P=0.000]。结论:同种异体肌腱微创解剖重建踝关节外侧韧带治疗慢性踝关节外侧不稳,短期内可有效缓解踝关节疼痛症状、改善踝关节功能。

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备注/Memo

备注/Memo:
基金项目:浙江中医药大学附属医院科研专项(2021FSYYZZ09) 通讯作者:庄汝杰 E-mail:rujiezhuang@163.com
更新日期/Last Update: 1900-01-01