Sun Yaning, Wang Huijuan, Tang Yuchao, Zhao Haitao, Qin Shiji, Zhang Fengqi
Department of Foot and Ankle Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, PR China.
Department of Histology and Embryology, Hebei Medical University, Shijiazhuang 050017, PR China.
Foot Ankle Surg. 2019 Apr;25(2):242-246. doi: 10.1016/j.fas.2017.11.001. Epub 2017 Nov 23.
This study aimed to report our institution's experience in the treatment of chronic lateral ankle instability using the anterior half of the peroneus longus tendon (AHPLT) to reconstruct the lateral ligament.
This retrospective study included 32 consecutive patients with chronic lateral ankle instability who underwent surgery from January 2013 to December 2014. All patients had failed to resolve with conservative treatment. A total of 32 ankles underwent AHPLT transfer. Patients returned for a clinical and radiologic follow-up evaluation at an average of 28 (range, 24-35) months postoperatively. Outcomes were assessed by comparison of pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale pain scores, and Karlsson scores, and the radiographic assessment including talar tilt and anterior talar translation.
Thirty-two patients (32 ankles) (100%) returned for final evaluation. All patients had an excellent or good outcome on patient subjective self-assessment, pain scores, AOFAS scores, and Karlsson scores at final follow-up. Ankle range of motion was not affected by lateral ankle reconstruction. The talar tilt was significantly reduced from a preoperative mean of 14.1±4.2° to 3.4±1.3° postoperatively (P<.001), and the anterior drawer was significantly reduced from a preoperative mean of 13.8±3.4mm to 3.6±1.5mm after lateral ankle ligamentous reconstruction (P<.001).
AHPLT transfer to reconstruct the lateral ligament resulted in a high percentage of successful results, with excellent ankle stability and not affected of ankle motion.
Level III-retrospective comparative study.
本研究旨在报告我院使用腓骨长肌腱前半部分（AHPLT）重建外侧韧带治疗慢性外侧踝关节不稳的经验。
这项回顾性研究纳入了2013年1月至2014年12月期间连续接受手术的32例慢性外侧踝关节不稳患者。所有患者经保守治疗均未痊愈。共对32个踝关节进行了AHPLT转移术。患者在术后平均28个月（范围24 - 35个月）返回进行临床和影像学随访评估。通过比较术前和术后美国矫形足踝协会（AOFAS）评分、视觉模拟量表疼痛评分和卡尔森评分，以及包括距骨倾斜和距骨前移的影像学评估来评估结果。
32例患者（32个踝关节）（100%）返回进行最终评估。在最终随访时，所有患者在患者主观自我评估、疼痛评分、AOFAS评分和卡尔森评分方面均取得了优良结果。踝关节活动范围未受外侧踝关节重建影响。距骨倾斜度从术前平均14.1±4.2°显著降低至术后3.4±1.3°（P <.001），外侧踝关节韧带重建后前抽屉试验从术前平均13.8±3.4mm显著降低至3.6±1.5mm（P <.001）。
AHPLT转移重建外侧韧带取得了较高的成功率，踝关节稳定性良好且未影响踝关节活动。
III级——回顾性比较研究。
