[1]杨宗宇△ 刘非 崔亮 齐少霞 李森田 李莹丽 张国瑜 孙佩宇.短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳临床疗效比较[J].中国中医骨伤科杂志,2018,26(09):28-31.
　YANG Zongyu LIU Fei CUI Liang QI Shaoxia LI Sentian LI Yinli ZHANG Guoyu SUN Peiyu.Comparison of Shortening Suture Reconstruction and Allogeneic Tendon Transplantation for Chronic Ankle Instability[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(09):28-31.
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短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳临床疗效比较()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年09期
页码:
28-31
栏目:
临床研究
出版日期:
2018-09-06

文章信息/Info

Title:
Comparison of Shortening Suture Reconstruction and Allogeneic Tendon Transplantation for Chronic Ankle Instability
文章编号:
1005-0205(2018)09-0028-04
作者:
杨宗宇1△ 刘非1 崔亮1 齐少霞1 李森田1 李莹丽1 张国瑜2 孙佩宇3
1河北沧州中西医结合医院(河北 沧州,061001) 2河北孟村回族自治县医院 3北京中医医院骨伤科
Author(s):
YANG Zongyu1△ LIU Fei1 CUI Liang1 QI Shaoxia1 LI Sentian1 LI Yinli1 ZHANG Guoyu2 SUN Peiyu3
1Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061001,Hebei China; 2People Hospital of Mengcun Hui Autonomous County,Cangzhou 061400,Hebei China; 3Department of Orthopedic,Beijing Traditional Chinese Medicine Hospital,Beijing 100010,China.
关键词:
短缩缝合止点重建术;  同种异体肌腱移植术;  踝关节镜;  慢性踝关节不稳
Keywords:
Keywords: shortening suture reconstruction;  allogeneic tendon transplantation;  ankle arthroscopy;  chronic ankle instability
分类号:
R684
文献标志码:
A
摘要:
目的:比较短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳(CAI)的临床疗效。方法:回顾分析了2015年6月至2017年12月在本科就诊住院的CAI患者35例,男性20例,女性15例; 平均年龄为26.1岁(16～47岁).其中17例行短缩缝合止点重建术治疗,18例行同种异体半腱肌重建受损踝关节外侧副韧带。两组术中均使用踝关节镜探查处理距骨骨软骨损伤。分别于术前、术后6周、术后3个月、术后6个月对患者进行美国足与踝关节协会踝与后足功能评分及Tegner 运动水平评分,踝关节内翻应力位X线片测量距骨倾斜角并记录。记录患足术后疼痛、肿胀、再次扭伤情况,内翻应力试验及前抽屉试验检查。结果:所有患者均得到随访,无脱落病例。所有切口均一期愈合,无切口液化感染等并发症。术后踝关节前抽屉试验均转为阴性。两组患者术后AOFAS评分及Tegner评分、距骨倾斜角变化均较术前明显改善,两组间差异无统计学意义(P>0.05).结论:短缩缝合止点重建与同种异体肌腱移植重建踝关节外侧副韧带治疗慢性踝关节不稳均能够获得良好的临床疗效。
Abstract:
Abstract Objective:To discuss the clinical efficacy of shortening suture reconstruction and allogeneic tendon transplantation for chronic ankle instability.Methods:A retrospective analysis of 35 cases of CAI patients in my department from June 2015 to December 2017 was reviewed.There were 20 males and 15 females with a mean age of 26.1 years(range from 16 to 47 years).Seventeen of them were treated with shortening suture reconstruction,and eighteen patients underwent anatomical reconstruction of LCAL with a semitendinosus autograft.In both groups,ankle arthroscopy was used for the treatment of osteochondral injury of the talus.The AOFAS scores and Tegner scores were assessed in the patients respectively in the preoperative and postoperative 6 weeks,3 months after operation,postoperative 6 months, and the varus stress radiographs was taken to record the talar tilt angle.Postoperative pain,swelling and resprain were recorded,and varus stress test and anterior drawer test were performed.Results:All patients were followed up without shedding cases.All the incisions were healed in the first stage,and there were no complications such as incisional liquefaction infection.After surgery,the test of the anterior drawer of the ankle was negative.Postoperative AOFAS score and Tegner score of the two groups were significantly improved compared with that before surgery,and there was no statistically significant difference between the two groups(P>0.05).Conclusion:Both shortening suture reconstruction and allogeneic tendon transplantation for chronic ankle instability can achieve good clinical efficacy.

参考文献/References:

[1] 张言,梁晓军.慢性踝关节外侧不稳的解剖修复治疗进展[J].中国修复重建外科杂志,2016,30(12):1551-1555.
[2] 杨宗宇,刘非,崔亮,等.踝关节镜手术联合改良Bromstrom术治疗慢性踝关节不稳合并骨软骨损伤[J].中医正骨,2017,29(8):72-75.
[3] 杨雷,陆伟,吴冰,等.半腱肌腱与同种异体肌腱解剖重建踝关节外侧副韧带治疗慢性踝关节不稳的疗效比较[J].中国骨与关节损伤杂志,2016,31(5):489-492.
[4] 董相宇,曾效力,何秀珍,等.MRI和高频超声对踝关节外侧副韧带损伤的诊断价值比较[J].现代医用影像学,2015,24(2):140-144.
[5] Bohndorf K.Osteochondritis(osteochondmsis)dissecans:a review and new MRI classification[J].Eur Radiol,1998,8(1):103-112.
[6] Kitaoka HB AIJ,Adelaar RS.Clinical rating system for the ankle-hindfoot,midfoot,hallux and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[7] Hambly K.The use of tegner activitity scale for articular cartilage repair of the knee:a systematic review[J].Knee Surg Sports Traumatol Arthrosc,2011,19(4):604-614.
[8] 王雪,王成伟,郭鹏超,等.腓骨长肌及同种异体肌腱重建踝关节外侧副韧带的临床对比研究[J].中华骨与关节外科杂志,2015,8(4):314-319.
[9] 鹿军,张言,张银刚,等.应用Gould-Brostm术编织缝合外侧副韧带治疗慢性踝关节外侧不稳的中短期疗效观察[J].中华骨与关节外科杂志,2016.9(4):287-291.
[10] 张昊,解冰,薛海鹏,等.慢性踝关节不稳诊断与治疗的研究进展[J].中国骨伤,2016,29(12):1160-1163.
[11] 杨宗宇,刘非,崔亮,等.同种异体半腱肌解剖重建距腓前韧带和跟腓韧带治疗慢性踝关节外侧不稳[J].中医正骨,2017,29(9):64-66.
[12] Buerer Y,Winkler M,Burn A,et al.Evaluation of a modified Broström-Gould procedure for treatment of chronic lateral ankle instability:a retrospective study with critical analysis of outcome scoring[J].Foot Ankle Surg,2013,19(1):36-41.
[13] Cho BK,Kim YM,Park KJ,et al.A prospective outcome and cost-effectiveness comparison between two ligament reattachment techniques using suture anchors for chronic ankle instability[J].Foot Ankle Int,2015,36(2):172-179.
[14] 杨珍,胡亚哲.慢性踝关节不稳的诊断与修复[J].中国组织工程研究,2014,18(9):1434-1440.
[15] 杨克强,黄长明,谷孝将,等.自体半腱肌腱重建距腓前韧带和跟腓韧带治疗慢性踝关节外侧不稳[J].中国骨与关节损伤杂志,2014,29(8):791-793.
[16] Yasui Y,Takao M,Miyamoto W,et al.Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus[J].Arch Orthop Trauma Surg,2014,134(6):821-827.
[17] Wainright WB,Spritzer CE,Lee JY,et al.The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics[J].Am J Sports Med,2012,40(9):2099-2104.
[18] 华英汇,陈世益.慢性踝关节不稳定的外科治疗进展[J].中国医学前沿杂志:电子版,2013,5(3):8-11.
[19] Lee KT,Park YU,Kim JS,et al.Long-term results after modified Brostrom procedure without calcaneofibular ligament reconstruction[J].Foot Ankle Int,2011,32(2):153-157.
[20] 江东,胡跃林,焦晨,等.慢性踝关节外侧不稳合并骨软骨损伤术后中期随访报告[J].中国微创外科杂志,2015,15(8):673-675.
[21] Golditz T,Steib S,Pfeifer K,et al.Functional ankle instability as a risk factor for osteoarthritis:using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes[J].Osteoarthritis Cartilage,2014,22(10):1377-1385.
[22] Lee J,Hamilton G,Ford L.Associated intra-articular ankle pathologies in patients with chronic lateral ankle instability:arthroscopic findings at the time of lateral ankle reconstruction[J].Foot Ankle Spec,2011,4(5):284-289.
[23] Cha SD,Kim HS,Chung ST,et al.Intra-articular lesions in chronic lateral ankle instability:comparison of arthroscopy with magnetic resonance imaging findings[J].Clin Orthop Surg,2012,4(4):293-299.

备注/Memo

备注/Memo:
基金项目:沧州市科技局支撑计划项目(2017277) △通信作者 E-mail:yangzongyu-918@163.com
更新日期/Last Update: 2018-09-06