使用自体腘绳肌腱进行解剖学关节镜下距腓前韧带和跟腓韧带重建:安全创建解剖学腓骨隧道

Anatomical Arthroscopic Anterior Talofibular Ligament and Calcaneofibular Ligament Reconstruction Using an Autogenic Hamstring Tendon: Safe Creation of Anatomical Fibular Tunnel.

作者信息

Higashiyama Reiji, Aikawa Jun, Iwase Dai, Takamori Yasuyuki, Watanabe Eiichiro, Takaso Masashi

机构信息

Department of Orthopaedic Surgery, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan.

Department of Orthopaedic Surgery, Fuji Orthopaedic Surgery Hospital, Fuji, Shizuoka, Japan.

出版信息

Arthrosc Tech. 2019 Feb 4;8(3):e215-e222. doi: 10.1016/j.eats.2018.10.016. eCollection 2019 Mar.

Abstract

Ankle sprains are the most common lower extremity injuries associated with sports activity. Although ligament repair techniques are popular, reconstruction methods using free tendons are considered when the ligament remnant is insufficiently strong, when high-demand athletes sustain repeat ankle sprains, or in revision cases after repair. Recently, some arthroscopic reconstruction techniques have been reported. The distal fibular end is thin; therefore, surgeons must be careful while drilling the fibular tunnel. This report indicates the safe creation method of an anatomical fibular tunnel during anatomical arthroscopic reconstruction of the anterior talofibular ligament and calcaneofibular ligament. This also provides a stronger reconstruction using a 2-strand tendon graft for the anterior talofibular ligament substitute, which is thought to have less risk for postoperative graft failure.

摘要

踝关节扭伤是与体育活动相关的最常见的下肢损伤。尽管韧带修复技术很常用,但当韧带残端不够强壮、高要求的运动员反复发生踝关节扭伤或修复后的翻修病例时,会考虑使用游离肌腱的重建方法。最近,已有一些关节镜重建技术的报道。腓骨远端很薄,因此外科医生在钻腓骨隧道时必须小心。本报告指出了在距腓前韧带和跟腓韧带的解剖学关节镜重建过程中安全创建解剖学腓骨隧道的方法。这也为距腓前韧带替代物使用双股肌腱移植物提供了更强的重建,据认为术后移植物失败的风险较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a23/6470364/f46d6b8e8ba6/gr1.jpg

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