Caals Maarten, Mertens Peter, Spaepen Dominique, Buedts Kris
Acta Orthop Belg. 2020 Mar;86(1):95-101.
In cases of chronic instability of the lateral ligament complex following an ankle sprain, operative stabilization should be considered when conservative treatment fails. The purpose of this study is to determine the outcome of a percutaneous stabilization of the lateral ligament complex with a gracilis tendon auto-graft, after an adjuvant arthroscopy of the ankle joint. We retrospectively reviewed the medical files of patients who underwent this surgery performed by the senior author. Between 2012 and 2015, 18 ankles were stabilized. Clinical results were assessed at final follow-up at a mean post-operative period of 25 months (range, 10-42 months). The mean post-operative AOFAS ankle-hindfoot score was 90 points (range, 48-100 points). The mean Karlsson Ankle Functional Score was 85 points (range, 37-100 points). The mean VAS score was 1.2 (range, 0-7). Concomitant procedures were performed on 14 out of 18 ankles. In conclusion, we state that this arthroscopically assisted percutaneous technique is a viable treatment option for chronic lateral ankle instability. It offers an alternative for the modified Broström procedure when tissue quality is poor and carries all the advantages of a minimally invasive procedure.
对于踝关节扭伤后外侧韧带复合体慢性不稳定的病例，保守治疗失败时应考虑手术稳定治疗。本研究的目的是确定在踝关节辅助关节镜检查后，采用股薄肌腱自体移植对外侧韧带复合体进行经皮稳定治疗的效果。我们回顾性分析了由资深作者实施该手术的患者的病历。2012年至2015年期间，18个踝关节接受了稳定治疗。在术后平均25个月（范围10 - 42个月）的最终随访时评估临床结果。术后AOFAS踝 - 后足平均评分为90分（范围48 - 100分）。Karlsson踝关节功能平均评分为85分（范围37 - 100分）。VAS平均评分为1.2（范围0 - 7）。18个踝关节中有14个进行了联合手术。总之，我们认为这种关节镜辅助经皮技术是治疗慢性外侧踝关节不稳定的一种可行选择。当组织质量较差时，它为改良Broström手术提供了一种替代方法，并具有微创手术的所有优点。
