Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Sports Medicine, Quanzhou Orthopedic-Traumatological Hospital, Fujian University of Traditional Chinese Medicine, Quanzhou, Fujian, China.
J Foot Ankle Surg. 2024 Jan-Feb;63(1):27-32. doi: 10.1053/j.jfas.2023.08.006. Epub 2023 Aug 18.
The purpose of this paper is to assess the prevalence and injury patterns of the calcaneofibular ligament (CFL) in chronic lateral ankle instability (CAI) patients using ultrasound imaging. This retrospective study included 938 ankle ultrasound images from January 2016 to May 2018. The patients' demographic data and the injury pattern classified by the injury location and the remnant quality were recorded and correlated using t tests, Fisher's exact tests, and post hoc tests accordingly. Of the 938 CAI patients, CFL injury was found in 408/938 (44%). Among the 408 anterior talofibular ligament (ATFL) and CFL complex injury patients, 71/408 (17%) presented with a completely absorbed ATFL, whereas 13/71 (18%) presented with an absorbed CFL. The total CFL absorption proportion in all patients was relatively low (30/938 = 3%). Post hoc tests indicated a negative association between thickened ATFLs and complex injuries. In addition, a positive association existed between absorbed ATFLs and complex injuries as well as absorbed ATFLs and absorbed CFLs. Thus, the results indicated that total tearing and absorption injury patterns of the CFL in CAI are not common. Even when the ATFL is absorbed, only approximately one-fifth (13/71 = 18%) of CFLs require reconstruction, suggesting that it is unnecessary to routinely repair or reconstruct CFLs in all lateral ligament surgeries.
本文旨在通过超声影像学评估慢性外侧踝关节不稳定（CAI）患者的跟腓韧带（CFL）的患病率和损伤模式。这项回顾性研究纳入了 2016 年 1 月至 2018 年 5 月的 938 例踝关节超声图像。记录了患者的人口统计学数据和根据损伤位置和残端质量分类的损伤模式，并使用 t 检验、Fisher 确切检验和事后检验进行了相关性分析。在 938 例 CAI 患者中，发现 CFL 损伤 408/938（44%）。在 408 例前距腓韧带（ATFL）和 CFL 复合体损伤患者中，71/408（17%）的 ATFL 完全吸收，而 13/71（18%）的 CFL 吸收。所有患者的 CFL 总吸收比例相对较低（30/938=3%）。事后检验表明，增厚的 ATFL 与复合体损伤呈负相关。此外，吸收的 ATFL 与复合体损伤以及吸收的 ATFL 与吸收的 CFL 之间呈正相关。因此，结果表明，CAI 中 CFL 的完全撕裂和吸收损伤模式并不常见。即使 ATFL 吸收，也只有大约五分之一（13/71=18%）的 CFL 需要重建，这表明在所有外侧韧带手术中，没有必要常规修复或重建 CFL。
