Wang Xu, Ma Xin, Zhang Chao, Wang Chen, Huang Jia-zhang
Department of Orthopaedics, Huashan Hospital, University of Fudan, Shanghai, China.
Orthop Surg. 2014 Aug;6(3):223-8. doi: 10.1111/os.12125.
To explore the efficacy of overlapping suture-anchor fixation for treatment of chronic deltoid ligament injury.
Seventeen patients (11 men, 6 women of mean age 32.1 years [range, 18-58 years]) who had undergone surgery for chronic deltoid ligament injury from January 2007 to December 2011 were retrospectively analyzed. Preoperatively, they had undergone bilateral weight-bearing posterior-anterior radiographs, (MRI) and ultrasound examinations of the ankle. Ankle arthroscopy was performed to confirm the diagnosis, followed by surgery to clear intra-articular proliferating synovial tissues and remove cartilage debris and scar tissue. The deep layer of the deltoid ligament was sutured onto the tip of the medial malleolus and its superficial layer sutured onto its periosteum and fixed with suture anchors. American Orthopedic Foot and Ankle Society (AOFAS) scoring system for the ankle-hindfoot was used to evaluate the ankles pre- and post-operatively.
The 17 patients were followed up for 12-34 months (mean 20.1 months). The angle between the long axes of the talus and first metatarsal and the hindfoot angle measured in a hindfoot alignment view (as described by Saltzman) were reduced from 5.4° ± 1.8° and 8.2° ± 2.6° preoperatively to 4.0° ± 0.9° and 5.3° ± 1.3° postoperatively, respectively. The mean AOFAS ankle-hindfoot score was 76.8 ± 7.0 preoperatively and 94.1 ± 3.3 at the last follow-up visit. Ten patients were scored as excellent, six as good, and one as fair. Pain was relieved in all patients and no patients had recurrent deltoid ligament injury.
Using suture anchors to treat chronic deltoid ligament injury has relatively satisfactory outcomes.
探讨重叠缝合法联合锚钉固定治疗慢性三角韧带损伤的疗效。
回顾性分析2007年1月至2011年12月期间因慢性三角韧带损伤接受手术治疗的17例患者（男11例，女6例，平均年龄32.1岁[范围18 - 58岁]）。术前，患者均接受了双侧负重前后位X线片、踝关节磁共振成像（MRI）及超声检查。行踝关节镜检查以明确诊断，随后进行手术清除关节内增生的滑膜组织，清除软骨碎屑及瘢痕组织。将三角韧带深层缝合至内踝尖端，浅层缝合至其骨膜并用锚钉固定。采用美国足踝外科协会（AOFAS）踝 - 后足评分系统对患者术前及术后的踝关节情况进行评估。
17例患者随访12 - 34个月（平均20.1个月）。距骨与第一跖骨长轴夹角及后足对线视图（如Saltzman所述）测量的后足角分别从术前的5.4°±1.8°和8.2°±2.6°降至术后的4.0°±0.9°和5.3°±1.3°。AOFAS踝 - 后足平均评分术前为76.8±7.0，末次随访时为94.1±3.3。10例患者评定为优，6例为良，1例为可。所有患者疼痛均缓解，无患者出现三角韧带损伤复发。
采用锚钉治疗慢性三角韧带损伤疗效较为满意。
