Liu S H, Jacobson K E
Department of Orthopaedic Surgery, UCLA School of Medicine 90024.
J Bone Joint Surg Br. 1995 Jan;77(1):55-9.
We have treated 45 patients (47 ankles) for chronic lateral instability by a new reconstructive procedure. The operation includes lateral shift of the entire lateral capsule-ligament complex and proximal advancement of the talocalcaneal ligament and the inferior extensor retinaculum. We reviewed 39 patients (39 ankles) at a mean of 4.6 years (2 to 7) after operation. There were 29 men and 10 women with an average age of 27 years (19 to 43); 11 of them were competitive college-level athletes and 28 were recreational athletes. The functional rating was excellent in 26 patients, good in 8, fair in 3 and poor in 2. Thirty-six patients (92%) were satisfied with the result and 34 (9 of 11 college-level athletes and 25 of 28 recreational athletes) have been able to return to their preinjury level of sport. At the last review, there had been only three episodes of recurrent ankle instability, all in recreational athletes; none had required further surgery. The unsatisfactory results were associated with pre-existing degenerative changes in the ankle.
我们采用一种新的重建手术方法治疗了45例（47个踝关节）慢性外侧不稳定患者。手术包括将整个外侧关节囊 - 韧带复合体向外移位以及距跟韧带和伸肌下支持带近端推进。我们在术后平均4.6年（2至7年）对39例患者（39个踝关节）进行了复查。其中男性29例，女性10例，平均年龄27岁（19至43岁）；他们中11人是大学水平的竞技运动员，28人是业余运动员。功能评级为优秀的有26例，良好的有8例，中等的有3例，差的有2例。36例患者（92%）对结果满意，34例（11名大学水平竞技运动员中的9例和28名业余运动员中的25例）能够恢复到受伤前的运动水平。在最后一次复查时，仅出现3次踝关节反复不稳定情况，均发生在业余运动员中；无人需要进一步手术。不满意的结果与踝关节先前存在的退行性改变有关。
