摘要
踝关节外侧韧带重建术是治疗慢性踝关节外侧不稳(CAI)的重要方法,但何时重建跟腓韧带(CFL)目前还存在争议。我们搜索了PubMed、Web of Science、Cochrane和EMBASE数据库自1980年10月至2017年7月已发表的文献,纳入所有评估或比较非同时重建CFL的改良手术方法治疗CAI的研究。关键词是"lateral ankle ligament"或"ankle instability"和"anterior talofibular ligament"和"calcaneofibular ligament"和"surg或operat或reconstruct"。应用纳入标准和排除标准后,最终共纳入一项随机对照试验和两项队列研究。随机对照试验得出,对于合并距下关节不稳的CAI患者,在重建距腓前韧带(ATFL)的基础上,还需重建CFL。两项队列研究均得出,对于距下关节稳定的CAI患者,仅重建ATFL而不重建CFL也可以获得良好的功能学和影像学结局。但对于CAI合并距下关节不稳的患者,其疗效劣于距下关节稳定的患者。因此,我们得出对于合并距下关节不稳的CAI患者,应考虑重建ATFL基础上,同时行CFL重建。
Lateral ankle ligament reconstruction is an important method for the treatment of chronic lateral ankle instability(CAI),but there is still controversy about when to reconstruct the calcaneal ligament(CFL).We searched the published literature of PubMed,Web of Science,Cochrane,and EMBASE databases from October1980to July2017to include all studies that assessed or compared improved surgical procedures for the treatment of CAI without simultaneous reconstruction of CFL.The keywords are lateral ankle ligament or ankle instability and anterior talofibular ligament and calcaneofibular ligament and(surg*or operat*or reconstruct*).After screening with inclusion criteria and exclusion criteria,a randomized controlled trial and two cohort studies were included.A randomized controlled trial showed that CFL should be reconstructed on the basis of reconstruction of(ATFL)of anterior talofibular ligament in CAI patients with subtalar instability.Both cohort studies showed that for CAI patients with stable subtalar joints,reconstructing ATFL without reconstructing CFL could also achieve good functional and imaging outcomes.However,for CAI patients with subtalar joint instability,the efficacy is inferior to those of patients with stable subtalar joint.Therefore,we concluded that for CAI patients with subtalar instability,we should consider reconstructing ATFL and CFL at the same time.
作者
张凯彬
蒋逸秋
桂鉴超
ZHANG Kaibin;JIANG Yiqiu;GUI Jianchao(Department of Kinetoarthrosis, Nanjing Medical University Affiliated Nanjing Hospital/First Nanjing Hospital, Nanjing 210006, China)
出处
《足踝外科电子杂志》
2018年第3期1-5,共5页
Electronic Journal of Foot and Ankle Surgery
基金
国家自然科学基金(81672210)
关键词
踝关节外侧韧带
跟腓韧带
踝关节外侧不稳
距下关节不稳
Lateral ankle ligament
Calcanofibular ligament
Lateral ankle instability
Subtalar instability
