Tarczyńska Marta, Sekuła Przemysław, Gawęda Krzysztof, Szubstarski Mateusz, Przybylski Piotr, Czekajska-Chehab Elżbieta
Department and Clinic of Orthopaedics and Traumatology, Medical University of Lublin, Lublin, Poland.
1st Department of Medical Radiology, Medical University of Lublin, Lublin, Poland.
Acta Radiol. 2020 Jun;61(6):783-788. doi: 10.1177/0284185119882661. Epub 2019 Nov 19.
In about 20-40% of patients, damage to the soft tissues surrounding the ankle leads to recurrent and chronic pain with signs of instability of the talus in the tibiofibular fork.
The aim of the study was to assess the usefulness of stress X-ray images in the diagnosis of long-term outcomes of conservative versus surgical treatment of anterolateral ankle instability.
Thirty patients with chronic ankle instability (CAI) were recruited for the study. The participants were divided into two groups. The first group consisted of 15 non-operatively treated individuals diagnosed with anterior talofibular ligament (ATFL) damage. The second group consisted of 15 patients who had undergone surgical reconstruction of the ATFL. In both groups of patients, the contralateral normal limb was used as a control. In all patients, anteroposterior and lateral view stress radiographs of both ankles were taken using the TELOS Stress Device (GA - III/E, Hungen, Germany).
Statistical tests showed that the surgically treated patients had a significantly greater ankle stability compared to the non-surgically treated patients ( = 0.001 for talar tilt angle and = 0.009 for anterior drawer distance). The results obtained in this study indicate that this method can also be used in postoperative assessment of the function of the reconstructed lateral ankle ligaments.
Stress radiography is a reliable and safe tool for diagnosing CAI. This imaging method is an objective instrument that can be successfully used in postoperative assessment of the function of the reconstructed ATFL.
在约20% - 40%的患者中，踝关节周围软组织损伤会导致反复的慢性疼痛，并伴有距骨在胫腓叉中不稳定的迹象。
本研究旨在评估应力X线影像在诊断踝关节前外侧不稳定保守治疗与手术治疗长期疗效中的作用。
招募30例慢性踝关节不稳定（CAI）患者进行研究。参与者分为两组。第一组由15例被诊断为距腓前韧带（ATFL）损伤的非手术治疗个体组成。第二组由15例接受了ATFL手术重建的患者组成。两组患者均将对侧正常肢体作为对照。所有患者均使用TELOS应力装置（GA - III/E，德国洪根）拍摄双踝关节的前后位和侧位应力X线片。
统计检验表明，与非手术治疗患者相比，手术治疗患者的踝关节稳定性显著更高（距骨倾斜角=0.001，前抽屉距离=0.009）。本研究获得的结果表明，该方法也可用于术后评估重建的外侧踝关节韧带的功能。
应力X线摄影是诊断CAI的可靠且安全的工具。这种成像方法是一种客观的仪器，可成功用于术后评估重建的ATFL的功能。
