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使用腓骨长肌腱前半部分进行外侧踝关节韧带重建。

Lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon.

作者信息

Kim Hyong Nyun, Jeon June Young, Dong Quanyu, Noh Kyu Cheol, Chung Kook Jin, Kim Hong Kyun, Hwang Ji Hyo, Park Yong Wook

机构信息

Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, 948-1, Dalim-1dong, Youngdeungpo-gu, Seoul, 150-950, South Korea,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Jun;23(6):1877-85. doi: 10.1007/s00167-014-3072-8. Epub 2014 May 20.

Abstract

PURPOSE

The purpose of this study was to assess the results of a novel surgical technique for the treatment of chronic lateral ankle instability with attenuated or deficient ligamentous tissue that the modified Broström procedure could not be performed. A lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon has been performed.

METHODS

Thirty-four consecutive patients treated with lateral ankle ligament reconstruction using anterior half of the peroneus longus tendon were enrolled. Median age at surgery was 24 years (range 19-46 years). The clinical and radiologic outcomes were evaluated preoperatively and at a median of 21 months (range 12-51 months) follow-up.

RESULTS

The Karlsson-Peterson ankle score significantly improved from 58.2 ± 10.9 points preoperatively to 83.9 ± 7.0 points at the last follow-up. Mechanical stability was achieved. The mean talar tilt angle significantly improved from 15.7° ± 3.5° preoperatively to 4.6° ± 1.7° at the last follow-up, and the mean anterior talar translation significantly improved from 7.3 ± 2.6 mm preoperatively to 4.1 ± 1.7 mm at the last follow-up. Fifteen patients (52%) were very satisfied with the results, nine patients (31%) were satisfied, four patients (14%) were fair, and one patient (3%) was dissatisfied with the results.

CONCLUSIONS

Lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon can be a surgical option for chronic lateral ankle instability with attenuated or deficient ligaments.

LEVEL OF EVIDENCE

Case-series, Level IV.

摘要

目的

本研究旨在评估一种新型手术技术的治疗效果,该技术用于治疗慢性外侧踝关节不稳且韧带组织减弱或缺失而无法进行改良 Broström 手术的情况。已采用腓骨长肌腱前半部分进行外侧踝关节韧带重建。

方法

纳入 34 例连续接受腓骨长肌腱前半部分外侧踝关节韧带重建的患者。手术时的中位年龄为 24 岁(范围 19 - 46 岁)。术前及中位随访 21 个月(范围 12 - 51 个月)时评估临床和影像学结果。

结果

Karlsson - Peterson 踝关节评分从术前的 58.2 ± 10.9 分显著提高至末次随访时的 83.9 ± 7.0 分。实现了机械稳定性。平均距骨倾斜角从术前的 15.7° ± 3.5°显著改善至末次随访时的 4.6° ± 1.7°,平均距骨前移从术前的 7.3 ± 2.6 mm 显著改善至末次随访时的 4.1 ± 1.7 mm。15 例患者(52%)对结果非常满意,9 例患者(31%)满意,4 例患者(14%)评价一般,1 例患者(3%)对结果不满意。

结论

采用腓骨长肌腱前半部分进行外侧踝关节韧带重建可作为慢性外侧踝关节不稳且韧带减弱或缺失的一种手术选择。

证据级别

病例系列,四级。

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