摘要
目的比较全镜下加强版缝合增强修复术与胫前韧带最远束(anterior tibiofibular ligament's distal fascicle,ATiFL-DF)转位增强修复术治疗大部分距腓前韧带(anterior talofibular ligament,ATFL)损伤的临床疗效。方法选取2021年3月至2023年6月于中山市东升医院及暨南大学附属第一医院行增强修复术的100例大部分ATFL损伤患者作为研究对象,采用随机数字表法分为A组与B组,每组50例。A组采用ATiFL-DF转位增强修复术,B组采用加强版缝合增强修复术。比较两组手术前后不同时间点前抽屉试验分级、美国骨科足踝协会(American Orthopedic Foot and Ankle Society,AOFAS)评分、视觉模拟评分法(visual analogue scale,VAS)评分。结果术前、术后6、12、24个月,两组前抽屉试验分级比较差异无统计学意义。术前,两组AOFAS评分比较差异无统计学意义;术后6、12、24个月,B组AOFAS评分均高于A组,差异有统计学意义(P<0.05)。术前、术后6、12、24个月,两组VAS评分比较差异无统计学意义。结论加强版缝线修复术可常规用于大部分ATFL损伤患者,其操作简单,且无须离断患者固有架构,而对于损伤后ATFL断端质量较差者,考虑到术后稳定性的潜在风险,ATiFL-DF转位增强修复术或许是更好的选择。两种术式对韧带的修复效果和缓解术后疼痛的效果相当,其中加强版缝合增强修复术改善踝关节功能的作用更显著。
Objective To compare the clinical efficacy of arthroscopic augmented suture repair and anterior tibiofibular ligament's distal fascicle(ATiFL-DF)transposition augmentation repair in the treatment of most anterior talofibular ligament(ATFL)injuries.Methods A total of 100 patients who underwent enhanced suture and enhanced repair or ATiFL-DF transposited and enhanced repair for most ATFL in Zhongshan Dongsheng Hospital and the First Affiliated Hospital of Jinan University from March 2021 to June 2023 were selected as the research subjects,they were divided into the group A and the group B by the random number table method,with 50 cases in each group.Group A was treated with ATiFL-DF transposition enhanced repair surgery,while the group B was treated with augmented suture repair.The anterior drawer test grades,American Orthopedic Foot and Ankle Society(AOFAS)scores,and visual analogue scale(VAS)scores at different time points before and after the surgery were compared between the two groups.Results There were no statistically significant differences in the classification of the anterior drawer test between the two groups before the surgery and at 6,12,and 24 months after the surgery.Before the surgery,there was no statistically significant difference in the AOFAS scores between the two groups;at 6,12 and 24 months after the surgery,the AOFAS scores in the group B were all higher than those in the group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the VAS scores between the two groups before the surgery and at 6,12 and 24 months after the surgery.Conclusion Augmented suture repair can be routinely used for most ATFL injuries due to its simplicity and preservation of the patient's inherent architecture.However,for patients with poor quality of the injured ATFL end,considering the potential risk of postoperative stability,ATiFL-DF transposition augmentation repair may be a better choice.The repair effects of the ligaments and the effects of relieving postoperative pain of the two surgical methods are comparable.Among them,the augmented suture repair has a more significant effect on improving ankle joint function.
作者
何林果
洪峰
吴运成
侯辉歌
郑勇杰
HE Linguo;HONG Feng;WU Yuncheng;HOU Huige;ZHENG Yongjie(Department of Orthopedics,Zhongshan Dongsheng Hospital,Zhongshan,Guangdong,528400,China;Bone and Joint Surgery and Sports Medicine Center,The First Affiliated Hospital of Jinan University,Guangzhou,Guangdong,510000,China)
出处
《当代医学》
2025年第2期67-71,共5页
Contemporary Medicine
基金
中山市2022年度社会公益医疗卫生重点项目(2022B1052)。
关键词
关节镜
踝关节不稳
距腓前韧带
韧带修复
Arthroscopy
Ankle instability
Anterior talofibular ligament
Ligament repair
