全踝关节镜手术治疗陈旧性外踝撕脱骨折并发踝关节不稳的疗效观察

doi:10.3760/cma.j.cn101202-20200227-00052

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摘要目的探讨全踝关节镜手术治疗陈旧性外踝撕脱骨折并发踝关节不稳的临床疗效及可行性。方法回顾性分析。纳入2017年1月—2019年1月徐州市中心医院骨科陈旧性外踝撕脱骨折并发踝关节不稳患者21 例(21足),其中男12例、女9例,年龄16～63 (31.34±12.17)岁, 右侧13例、左侧8例。21足均采用全踝关节镜下修复治疗,术后定期门诊随访、拍摄影像学资料,观察患者踝关节稳定性、踝关节外观及步态等;通过对比术前与末次随访时疼痛视觉模拟评分(VAS)、美国骨科足踝外科协会(AOFAS)评分及足踝功能测试(FAAM)评分以评价手术疗效。结果 21例中,7例采用加压钉固定骨块,14例采用带线锚钉重建腓骨侧止点。术后患者切口均获得一期愈合,未出现神经、血管、肌腱损伤等并发症。21例患者随访8～16 (12.63±6.80)个月。末次随访时,患者无感觉过敏现象以及瘢痕触痛,患者对切口外观恢复满意,踝关节正常活动恢复,踝关节抽屉试验阴性,未出现患肢肌肉萎缩,均恢复正常行走步态;末次随访时,VAS由术前的(5.71±1.19)分改善为(0.71±0.14)分,AOFAS评分由术前的(69.43±6.38)分提升到(88.52±0.79)分,FAAM由术前的(64.31±9.70) 分提高为(86.37± 5.24)分,与术前比较差异均有统计学意义(t=27.386、19.923、8.310,P值均<0.01)。结论全踝关节镜下治疗陈旧性外踝撕脱骨折并发踝关节不稳具有创伤小、临床疗效确切、患者满意度高等优点,是治疗陈旧性外踝撕脱骨折并发踝关节不稳安全、可靠的方法。

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关键词 ：踝损伤, 关节镜检查, 外踝撕脱骨折, 距腓前韧带, 踝关节不稳

Key words： Ankle injury Arthroscopy Lateral malleolus avulsion fracture Anterior talofibular ligament Ankle instability

收稿日期: 2020-02-27

通讯作者: 王爱国,Email:wangaiguo2008@163.com

引用本文:

常步青, 王爱国, 张在轶, 郝云甲, 冯仕明, 陶友伦, 范家强, 张述才. 全踝关节镜手术治疗陈旧性外踝撕脱骨折并发踝关节不稳的疗效观察[J]. 中华解剖与临床杂志, 2021, 26(1): 94-97.
Chang Buqing, Wang Aiguo, Zhang Zaiyi, Hao Yunjia, Tao Youlun, Fan Jiaqiang, Zhang Shucai. Observation of the effect of total ankle arthroscopy on the treatment of old lateral malleolus avulsion fracture complicated with ankle instability. Chinese Journal of Anatomy and Clinics, 2021, 26(1): 94-97.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20200227-00052 或 http://www.cjac.com.cn/CN/Y2021/V26/I1/94

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