小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤的疗效观察

doi:10.11958/20221841

天津医药 ›› 2023, Vol. 51 ›› Issue (4): 432-435.doi: 10.11958/20221841

小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤的疗效观察

孙若宾(), 尚林, 许少刚()

1 郑州市骨科医院急诊科（邮编450052）
2 郑州市骨科医院足踝外科（邮编450052）

收稿日期:2022-11-29 修回日期:2022-12-25 出版日期:2023-04-15 发布日期:2023-04-20
通讯作者: 许少刚 E-mail:26971185@qq.com;138965562@qq.com
作者简介:孙若宾（1985），男，主治医师，主要从事四肢创伤骨科、脊柱相关疾病的诊断及治疗方面研究。E-mail：26971185@qq.com

Clinical observation of the modified Broström procedure augmented with suture-tape repair of anterior talofibular ligament injury using mini-open incision

SUN Ruobin(), SHANG Lin, XU Shaogang()

1 Department of Emergency, Zhengzhou Orthopedic Hospital, Zhengzhou 450052, China
2 Department of Foot and Ankle Surgery, Zhengzhou Orthopedic Hospital, Zhengzhou 450052, China

Received:2022-11-29 Revised:2022-12-25 Published:2023-04-15 Online:2023-04-20
Contact: XU Shaogang E-mail:26971185@qq.com;138965562@qq.com

孙若宾, 尚林, 许少刚. 小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤的疗效观察[J]. 天津医药, 2023, 51(4): 432-435.

SUN Ruobin, SHANG Lin, XU Shaogang. Clinical observation of the modified Broström procedure augmented with suture-tape repair of anterior talofibular ligament injury using mini-open incision[J]. Tianjin Medical Journal, 2023, 51(4): 432-435.

摘要/Abstract

摘要：

目的探讨小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤的手术疗效。方法 17例慢性踝关节外侧不稳患者采取小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤，其中男11例，女6例，年龄28~56岁，平均（40.20±13.75）岁，体质量指数（BMI）30.12~35.10 kg/m²，平均（32.27±1.83）kg/m²。比较手术前后足踝结局评分（FAOS）和足踝功能测试（FAAM）评分，评估手术疗效。结果所有患者手术切口一期愈合，未出现神经、血管、肌腱损伤等并发症。17例患者获得12~24个月完全随访。FAOS评分由术前（57.10±11.32）分提高到（91.35±1.27）分（P<0.05），FAAM评分由术前（55.76±10.12）分提高到（91.10±0.69）分（P<0.05）。有2例在早期行走时感觉踝关节外侧有紧绷感，8周后症状消除。结论小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤可以有效减轻患者症状，提高踝关节功能。

关键词: 踝关节, 距腓前韧带损伤, Broström改良术, 人工韧带

Abstract:

Objective To explore the surgical treatment of the modified Broström procedure augmented with suture-tape repair of anterior talofibular ligament using mini-open incision. Methods A tatal of 17 patients with chronic lateral ankle instability underwent the modified Broström procedure augmented with suture-tape reconstruction of anterior talofibular ligament using mini-open incision. The patients included 11 males and 6 females, aged 28-56 years with a mean of (40.20±13.75) years. Body mass index (BMI) was 30.12-35.10 kg/m² with a mean of (32.27±1.83) kg/m². The FAOS and FAAM were used to evaluate the postoperative function of ankle. Results All patients had operation performed smoothly, without serious complications, and got incisions healed well. All 17 patients were followed up for 12-24 months. Compared with those preoperative, the FAOS (from 57.10±11.32 to 91.35±1.27, P<0.05) and FAAM (from 55.76±10.12 to 91.10±0.69, P<0.05) scores significantly improved at the latest follow-up and no complications, such as nerve, blood vessel and tendon injury. Two patients experienced tightness in the lateral ankle during early walking, and the symptoms were resolved after 8 weeks. Conclusion For the chronic lateral ankle instability, the modified Broström procedure augmented with suture-tape repair of anterior talofibular ligament using mini-open incision effectively reduces symptoms and get early rehabilitation, with definite effect.

Key words: ankle joint, anterior talofibular ligament injury, modified Broström procedure, artificial ligament

中图分类号:

R684.77

图/表 1

图1 典型病例手术前后改变患者男，50岁，左踝关节扭伤后疼痛1年，保守治疗无效。术前踝关节负重正位（A）和侧位（B）X线显示踝关节无关节炎、内外翻畸形；踝关节MRI横轴面（C）和冠状面（D）显示ATFL和CFL损伤；X线透视下行前抽屉试验（E）及距骨倾斜试验（F）均为阳性；术中新鲜化处理ATFL在外踝足印区（G），ATFL外踝足印区置入带人工韧带和ARthrex缝线的Swivelock锚钉（H），ARthrex缝线缝合ATFL残端和伸肌支持带（I），将1股人工韧带旋转拧入距骨骨道（J），术后切口外观（K），透视下再次行前抽屉试验（L）及距骨倾斜试验（M）均为阴性，术后1年踝关节MRI横轴面（N）显示距腓前韧带走行良好。

Fig.1 Changes in typical cases before and after surgery

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小切口Internal brace人工韧带联合Broström改良术修复距腓前韧带损伤的疗效观察

Clinical observation of the modified Broström procedure augmented with suture-tape repair of anterior talofibular ligament injury using mini-open incision

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