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慢性外踝不稳:手术治疗能否更上一层楼?

Chronic Lateral Ankle Instability: Can We Get Even Better with Surgical Treatment?

机构信息

Foot & Ankle Department, Hospital Moinhos de Vento, Avenida Juca Batista 8000, 18 Porto Alegre RS, Brazil CEP 91781-200.

Southern California Orthopedic Institute, 6815 Noble Avenue, Suite 200, Van Nuys, CA, USA.

出版信息

Foot Ankle Clin. 2023 Jun;28(2):321-332. doi: 10.1016/j.fcl.2023.01.004. Epub 2023 Mar 8.

Abstract

Lateral ligament attenuation may occur after repetitive ankle sprains, creating instability. Management of chronic ankle instability requires a comprehensive approach to mechanical and functional instability. Surgical treatment, however, is indicated when conservative treatment is not effective. Ankle ligament reconstruction is the most common surgical procedure to resolve mechanical instability. Anatomic open Broström-Gould reconstruction is the gold standard for repairing affected lateral ligaments and returning athletes to sports. Arthroscopy may also be beneficial for identifying associated injuries. In severe and long-standing instability, reconstruction with tendon augmentation could be necessary.

摘要

外侧韧带在反复踝关节扭伤后可能会出现松弛,从而导致不稳定。慢性踝关节不稳定的治疗需要综合考虑机械性和功能性不稳定。然而,当保守治疗无效时,手术治疗是必要的。踝关节韧带重建是解决机械性不稳定最常见的手术方法。解剖型开放式 Broström-Gould 重建是修复受影响的外侧韧带并使运动员重返运动的金标准。关节镜检查也有助于确定相关损伤。在严重和长期不稳定的情况下,可能需要肌腱增强重建。

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