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慢性踝关节不稳患者外侧韧带的解剖修复

Anatomical repair of lateral ligaments in patients with chronic ankle instability.

作者信息

Schmidt R, Benesch S, Friemert B, Herbst A, Claes L, Gerngross H

机构信息

Department of Surgery, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2005 Apr;13(3):231-7. doi: 10.1007/s00167-004-0562-0. Epub 2004 Nov 18.

Abstract

In a prospective study, 19 patients with chronic ankle instability underwent clinical and radiographic reexaminations 36 months after anatomical reconstruction. In addition, dynamic pedography was conducted and peroneal reaction time measured on a tilting platform for an evaluation of functional aspects. Prior to this examination, 32 patients had been asked to fill in a questionnaire and make a detailed subjective evaluation of current discomfort, stability, flexibility and sporting abilities. Eighty-eight percent of the patients reported satisfactory results; only 3% complained of persistent instability. In 71% the ability to take part in sports had improved after surgery, and 85% of the patients reported unrestricted walking abilities. Supination ability was impaired in 5% of the patients at the follow-up. The radiographic examination showed restored ankle stability with a significant reduction of talar tilt and talar translation; a postoperative increase in signs and symptoms of arthrosis was not observed. Dynamic pedography showed a large degree of symmetry of plantar pressure distribution after surgery. There were no significant differences in peroneal reaction time in the repaired and intact ankles. The results of the study show that it is possible to restore ankle stability with anatomical reconstruction without impairing the range of movement in the ankle joint complex. Progressive osteoarthrosis can be prevented.

摘要

在一项前瞻性研究中,19例慢性踝关节不稳患者在解剖重建术后36个月接受了临床和影像学复查。此外,进行了动态足底压力测定,并在倾斜平台上测量了腓骨反应时间,以评估功能方面的情况。在此次检查之前,32例患者被要求填写一份问卷,并对当前的不适、稳定性、灵活性和运动能力进行详细的主观评估。88%的患者报告结果满意;只有3%的患者抱怨存在持续的不稳定。71%的患者术后参与运动的能力有所提高,85%的患者报告行走能力不受限。随访时5%的患者旋后能力受损。影像学检查显示踝关节稳定性恢复,距骨倾斜和距骨移位明显减少;未观察到术后关节病体征和症状增加。动态足底压力测定显示术后足底压力分布有很大程度的对称性。修复侧和未受损侧踝关节的腓骨反应时间无显著差异。研究结果表明,通过解剖重建恢复踝关节稳定性的同时不损害踝关节复合体的活动范围是可行的。可以预防进行性骨关节炎。

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