Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12 Urumqi Middle Rd., Shanghai 200040, China.
Biomed Res Int. 2021 Feb 1;2021:3182745. doi: 10.1155/2021/3182745. eCollection 2021.
Chronic injuries of the distal tibiofibular syndesmosis are common in patients who fail to receive adequate diagnosis and timely treatment. Reconstruction of the distal tibiofibular syndesmosis with an autogenous tendon graft in these patients is effective, although relatively rarely reported.
To investigate clinical outcomes of syndesmosis reconstruction with an autogenous tendon graft for chronic injuries of the distal tibiofibular syndesmosis by reviewing the current literature.
An English literature search was conducted in the MEDLINE, CENTRAL, and Cochrane databases to identify published studies up to October 2017. Preset inclusion and exclusion criteria were applied to identify all eligible articles.
Five studies (all with level IV evidence) that included a total of 51 patients who underwent reconstruction with an autogenous tendon graft were identified. It was reported that the symptoms were relieved postoperatively, including obviously improved functional outcomes and restoration of motions and exercise capacity. The mean American Orthopedic Foot and Ankle Society scale score of 16 patients was 53 preoperatively and 89 postoperatively. The visual analogue scale score of 14 patients decreased from 82.4 preoperatively to 12.6 postoperatively. A total of 5 (9.8%) complication cases were reported.
Reconstruction of the distal tibiofibular syndesmosis with an autogenous tendon for chronic syndesmosis injury showed a good therapeutic effect in terms of both subjective symptoms and objective evaluation scores. The interosseous ligament could be an appropriate reconstruction target in the treatment of chronic syndesmosis injury.
未能得到充分诊断和及时治疗的患者，常发生慢性下胫腓联合损伤。对这些患者采用自体肌腱移植重建下胫腓联合，疗效确切，但相关报道较少。
通过回顾现有文献，探讨自体肌腱移植重建慢性下胫腓联合损伤的临床疗效。
在 MEDLINE、CENTRAL 和 Cochrane 数据库中进行英文文献检索，检索时间截至 2017 年 10 月，根据预先设定的纳入与排除标准，筛选出所有符合条件的研究。
共纳入 5 项研究（均为 IV 级证据），总计 51 例患者采用自体肌腱移植重建下胫腓联合。术后患者症状缓解，包括功能明显改善，运动和活动能力恢复。16 例患者的美国矫形足踝协会评分由术前的 53 分提高至术后的 89 分，14 例患者的视觉模拟评分由术前的 82.4 分降至术后的 12.6 分。共报道了 5 例（9.8%）并发症。
自体肌腱重建慢性下胫腓联合损伤，在主观症状和客观评估评分方面均取得了较好的疗效，骨间韧带可能是治疗慢性下胫腓联合损伤的合适重建靶位。
