距腓前韧带解剖修复治疗伴有外侧副韧带损伤的外踝撕脱骨折的临床效果

Abstract
Figure/Table
References (30)
Related Citation (7)

Download: PDF (808 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To compare the clinical effects of surgical repair and simple plaster immobilization on patients with lateral collateral ligament injury and lateral malleolar avulsion fracture, in order to provide reference for the clinical treatment of patients with lateral collateral ligament injury and lateral malleolus avulsion fracture. Methods A total of 63 patients with lateral collateral ligament injury and lateral malleolus avulsion fracture treated in Beijing Chaoyang Hospital, Capital Medical University, from August 2017 to June 2021 were included in this study. According to the surgical method, the included patients were divided into two groups. Thirty-three cases in group A were treated with anatomic repair of the anterior talofibular ligament (fixation and resection according to the size of the fracture fragment), and 30 cases in group B were treated with plaster immobilization. After treatment, the two groups were followed up regularly to observe the pain, range of motion, walking gait and movement status of the affected ankle joint. The visual analog scale (VAS) pain score, American orthopedic foot and ankle society (AOFAS) score, Karlsson-Peterso ankle joint function score, and talus anterior displacement were compared and analyzed before and after operation. Results There were statistically significant differences of the VAS scores between the two groups, time and interaction (P ＜ 0.05). Among them, the 6 and 18 months after operation in the two groups were lower than those before operation, and the 18 months after operation was lower than that at 6 months after operation, and the differences were statistically significant (P ＜ 0.05); 6 months after operation the VAS score of group A was lower than that of group B, and the difference was statistically significant (P ＜ 0.05). The postoperative Karlsson score of the two groups were higher than that before operation, while the group A was higher than the group B, and the differences were statistically significant (P ＜ 0.05). There were statistically significant differences of AOFAS score between the two groups, time and interaction (P ＜ 0.05). The AOFAS scores of the two groups at 1, 3, and 18 months after the operation were higher than those before the operation, while the AOFAS scores of the group A at the 3 and 18 months after the operation were higher than those at the 1 month after the operation, and the AOFAS scores of the two groups at 18 months after the operation were higher than those at 3 months after the operation, and the differences were statistically significant (P ＜ 0.05); the AOFAS score of group A was higher than that of group B at 3 and 18 months after operation, and the differences were statistically significant (P ＜ 0.05). There were statistically significant differences in the distance of talus advancement difference between the two groups, time and interaction (P ＜ 0.05). Among the two groups, the distance of talus advancement difference at 12 and 18 months after operation were lower than that before operation, while the distance of talus advancement difference at 18 months after operation was higher than that at 12 months after operation, and the differences were statistically significant (P ＜ 0.05); at 12 and 18 months after operation, the distance of talus advancement difference in group A were higher than that in group B, and the differences were statistically significant (P ＜ 0.05). Conclusion Anatomical repair of the anterior talofibular ligament in the treatment of avulsion fractures of the lateral malleolus with lateral collateral ligament injury is more effective than conservative plaster immobilization, with faster recovery and better joint stability.

Key words： Avulsion fracture of lateral malleolus Lateral collateral ligament injury of ankle Surgical treatment Conservative treatment

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	MA Hujing LIU Yang ZHOU Junlin▲

Cite this article:

MA Hujing LIU Yang ZHOU Junlin▲. Clinical effect of anatomical repair of anterior talofibular ligament in the treatment of lateral malleolus avulsion fracture with lateral collateral ligament injury#br#[J]. 中国医药导报, 2022, 19(9): 99-102,119.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I9/99

[1] 吴玉玲，周先珊，沈良册，等.水中平板运动在踝关节骨折内固定术后康复中的疗效分析[J].颈腰痛杂志，2016， 37（6）：522-524.
[2] 崔晓春.手法复位配合石膏固定对踝部骨折患者的治疗效果[J].中国医学创新，2019，16（11）：37-40.
[3] 侯宗辰，敖英芳，胡跃林，等.慢性踝关节不稳患者足底压力特征及相关因素分析[J].北京大学学报：医学版，2021，53（2）：279-285.
[4] Porter DA，Kamman KA. Chronic lateral ankle instability [J]. Foot Ankle Clin，2018，23（4）：61-67.
[5] Miklovic TM，Donovan L，Protzuk OA，et al． Acute lateral ankle sprain to chronic ankle instability：a pathway of dysfunction [J]. Phys Sportsmed，2018，46（1）：116-122.
[6] Aicale R，Maffulli N. Chronic Lateral Ankle Instability：Topical Review [J]. Foot AnkleInt，2020，41（12）：1571-1581.
[7] Neuschwander TB，Indresano AA，Hughes TH，et al. Footprint of the later alligament complex of the ankle [J]. Foot Ankle Int，2013，34（4）：582-586.
[8] Kakegawa A，Mori Y，Tsuchiya A，et al. Independent attachment of lateral ankle ligaments：anteriortal of ibularandcal cane of ibularligaments-Acadaveric study [J]. J Foot Ankle Surg，2019，58（4）：717-722.
[9] Chang AL，Mandell JC. Syndesmotic ligaments of the ankle：anatomy，multimodality imaging，and patterns of injury [J]. Curr Probl Diagn Radiol，2020，49（6）：452-459.
[10] 惠桂生，杨昆，袁炜庆，等.腓骨长肌肌腱前半部解剖重建距腓前韧带治疗慢性踝关节外侧不稳[J].中医正骨，2021，33（5）：394-399.
[11] 周云烽，徐达政，陈仲，等.踝关节外侧韧带的形态学分型及临床意义[J].中国临床解剖学杂志，2021，39（2）：121-125.
[12] 王国强，屈建国，渠海波，等.关节镜下Brostrm-Gould术治疗慢性踝关节外侧不稳[J].中国内镜杂志，2021， 27（1）：28-33.
[13] 吴俊德，陈兆军，马占华，等.急性踝关节外侧副韧带损伤的诊断和治疗进展[J].足踝外科电子杂志，2017，4（3）：51-54.
[14] 中国中西医结合学会骨伤科分会.外踝韧带损伤的中西医结合治疗专家共识[J].中华骨科杂志，2019，39（11）：653-659.
[15] 张成昌，杨柳，段小军.外踝韧带损伤的诊断与治疗进展[J].实用骨科杂志，2019，25（7）：625-628.
[16] Purevsuren T，Batbaatar M，Khuyagbaatar B，et al. Comparative evaluatin between anatomic and non-ana-tomic lateral ligament reconstruction techniques in the ankle joint：A computational study [J]. J Biomech Eng，2018.
[17] Ellera GJ，Soares AF，Bastiani CE，et al. Anterolateraltalar palpation：A complementary test for ankle instability [J]. Foot Ankle Surg，2018，24（6）：486-489.
[18] 魏增永，王波，罗建成，等.关节镜下清理联合外踝韧带修补治疗慢性踝关节外侧不稳[J].实用骨科杂志，2019， 25（7）：662-664.
[19] 郑旻，黄伟杰，滕跃，等.关节镜下韧带增强固定与改良Brostrom术治疗慢性踝关节外侧不稳定的效果比较[J].临床外科杂志，2020，28（4）：319-323.
[20] 赵金玲，MRI检查对膝关节半月板损伤的诊断价值分析[J].现代医用影像学，2019，28（1）：124-125.
[21] 马健东.多层螺旋CT（MSCT）与磁共振成像（MRI）对隐匿性骨折及骨挫伤的临床诊断价值[J].现代医用影像学，2019，28（11）：2465-2466.
[22] 李谓林，朱永展，魏世隽.关节镜下距腓前韧带修复技术的进展[J].中国矫形外科杂志，2020，28（20）：1879-1882.
[23] 卡内尔·贝蒂.坎贝尔骨科手术学：足踝外科第12版[M].王岩，唐康来，吴雪晖，译.北京：人民军医出版社，2015：3915.
[24] 陈挺霖.不同方法治疗急性踝关节外侧副韧带损伤的疗效比较[J].实用骨科杂志，2017，23（1）：21-24.
[25] 马滚韶，徐勤，罗裕强，等.改良Karlsson术治疗踝关节外侧副韧带慢性损伤的疗效分析[J].中国社区医师，2020，36（34）：18-19.
[26] 施晓剑，韩甲，刘宇，等.慢性踝关节不稳的病理机制和评估诊断研究进展[J].中国运动医学杂志，2019，38（9）：816-824.
[27] Cao S，Wang C，Zhang G，et al. In vivo Kinematics of Functional ankle instability patients during the stance phase of walking [J]. Cait Posture，2019，73：262-268.
[28] Anguish B，Sandrey MA.Two 4-Week Balance-Training Programs for Chronic Ankle Instability [J]. J Athl Train. 2018，53（7）：662-671.
[29] Fusco A，Giancotti GF，Fuchs PX，et al. Wobble board balance assessment in subjects with chronic ankle instability [J]. Gait Posture，2019，68（1）：352-356.
[30] Sierra-Guzmán R，Jiménez-Diaz F，Ramírez C，et al. WholeBody-Vibration Training and Balancein Recreational Athletes With Chronic Ankle Instability [J]. J Athl Train，2018，53（4）：355-363.