摘要
目的比较全踝关节镜下与常规切开手术下采用改良Broström术式治疗慢性踝关节不稳的临床疗效差异。方法分析2015年7月至2022年7月北部战区总医院收治的慢性踝关节不稳患者的临床资料。根据纳入与排除标准,最终纳入70例患者,将患者随机分为关节镜组(35例)与切开组(35例),两组均采用改良Broström术式。记录两组手术时间和围术期并发症,比较两组术后3、6及12个月美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分、Karlsson评分及可视疼痛评分(visual analog scale,VAS)差异,同时比较两组术前与术后12个月随访时前抽屉移位及距骨倾斜角,并记录患者重返原运动水平情况。结果关节镜组3例失访,切开组4例失访,最终63例(关节镜组32例、切开组31例)患者均完成术后1年规定随访。两组的手术时间及围术期并发症发生率比较,差异无统计学意义(P>0.05)。术后3、6、12个月随访时,两组AOFAS评分、Karlsson评分及VAS评分均较术前明显改善,差异有统计学意义(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。术后12个月随访时两组前抽屉移位及距骨倾斜角均较术前明显改善,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。两组重返原运动水平比例(50.0%vs 54.8%)比较,差异无统计学意义(P>0.05)。结论对于慢性踝关节不稳,全镜下改良Broström术式与常规切开手术均具有良好的临床疗效,术后早期疗效比较无差异。
Objective To compare the clinical outcomes of the modified Broström procedure performed using all-inside arthroscopy with those of conventional open surgery for the treatment of chronic ankle instability(CAI).Methods Clinical data from CAI patients between July 2015 and July 2022 were analysed retrospectively.According to the inclusion and exclusion criteria,70 patients were selected and divided into two groups:An all-inside arthroscopic group(35 patients)and an open surgery group(35 patients).Both groups underwent the modified Broström procedure.Operation time and perioperative complications were recorded.The American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score,Karlsson score and visual analogue scale(VAS)were assessed at 3,6 and 12 months after surgery.Anterior talar translation and talar tilt angle were compared preoperatively and at 12 months postoperatively.The number of patients in each group who returned to their original exercise level was also recorded and compared.Results Three patients in the arthroscopic group lost follow-up,and 4 patients in the open surgery group lost follow-up.Finally,63 patients(32 in the arthroscopic group and 31 in the open surgery group)completed the one-year follow-up after surgery.There were no significant differences in operation time or perioperative complications(P>0.05).At each follow-up time point,the AOFAS scores,the Karlsson scores,and the VAS scores had improved significantly in both groups compared to preoperative levels(P<0.05).However,there were no significant differences in these scores between the two groups.At the 12-month follow-up,anterior talar translation and the talar tilt angle had significantly improved compared to preoperative levels in both groups(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the proportion of patients returning to their original exercise level between the two groups(P>0.05).Conclusion For patients with CAI treated by the modified Broström procedure,there was no difference in early clinical outcomes between the all-inside arthroscopic and open surgery manners.
作者
田竞
韩天宇
解冰
Tian Jing;Han Tianyu;Xie Bing(Department of Orthopedics,General Hospital of Northern Theater Command,Shenyang Liaoning,110016,China)
出处
《生物骨科材料与临床研究》
2025年第5期55-59,共5页
Orthopaedic Biomechanics Materials and Clinical Study
