手术治疗距腓前韧带距骨侧止点撕脱骨折的疗效观察

doi:10.3760/cma.j.cn101202-20220102-00001

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摘要目的探讨开放性修复手术治疗距腓前韧带距骨侧止点撕脱骨折的临床疗效。方法回顾性研究。纳入2017年11月—2021年4月徐州仁慈医院足踝外科确诊为距腓前韧带距骨侧止点撕脱骨折的患者4例（4足）。其中男3例、女1例,年龄15~45岁（平均30.3岁）,右足2例、左足2例。患者均采用外踝前外侧小切口开放性修复手术治疗距腓前韧带的距骨侧止点撕脱骨折,术后石膏制动。观察项目：（1）记录患者骨折愈合的时间、末次随访时踝关节疼痛视觉模拟评分法（VAS）评分,美国足踝外科协会（AOFAS）踝-后足功能评分、踝关节功能评价Karlsson-Peterson评分。（2）术前及末次随访时测量距骨前移距离（ATT）、距骨倾斜角（TT）。结果 4例患者手术均顺利完成,术后均获随访8~25个月。（1）患者骨折愈合均良好,愈合时间3~5个月（平均3.8个月）。末次随访时,患者疼痛VAS评分为0~2分（平均1.3分）,AOFAS踝-后足评分为89~95分（平均92.8分）,Karlsson-Peterson评分为89~94分（平均91.5分）;患者1例踝关节疼痛消失,其余3例仅有轻微酸胀不适,不影响日常行走。（2）末次随访时ATT为（2.4±0.3）mm、TT为2.8°±0.8°,较术前（8.4±0.8）mm和10.0°±1.4°明显改善,差异均有统计学意义（t=14.40、19.62,P值均<0.001）。结论采用开放性小切口结合2枚锚钉修复距腓前韧带的距骨侧撕脱骨折,可有效恢复患者踝关节的稳定性。手术创伤小,操作简便,有临床推广价值。

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关键词 ：踝损伤, 外侧韧带, 踝, 慢性踝关节不稳, 距腓前韧带, 撕脱骨折, 距骨

Key words： Ankle injuries Lateral ligament ankle Chronic lateral ankle instability Anterior talofibular ligament Avulsion fracture Talus

收稿日期: 2022-01-02

通讯作者: 石荣剑,Email：davyzheng93006@163.com

引用本文:

曹广超, 石荣剑, 李亮, 周吉, 赵亮, 杨龙, 俞光荣. 手术治疗距腓前韧带距骨侧止点撕脱骨折的疗效观察[J]. 中华解剖与临床杂志, 2022, 27(9): 656-659.
Cao Guangchao, Shi Rongjian, Li Liang, Zhou Ji, Zhao Liang, Yang Long, Yu Guangrong. Surgical treatment for avulsion fracture of lateral talar insertion of anterior talofibular ligament. Chinese Journal of Anatomy and Clinics, 2022, 27(9): 656-659.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20220102-00001 或 http://www.cjac.com.cn/CN/Y2022/V27/I9/656

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