BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instabilit...BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.展开更多
Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients....Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL.The clinical manifestations of acute injury to the ATFL include pain,swelling,and dysfunction.At present,non-surgical treatment is the first choice for acute injury of the ATFL.The standard treatment strategy involves the“peace and love”principle.After initial treatment in the acute phase,personalized rehabilitation training programs can be followed.These may involve proprioception training,muscle training,and functional exercise to restore limb coordination and muscle strength.Static stretching and other techniques to loosen joints,acupuncture,moxibustion massage,and other traditional medical treatments can relieve pain,restore range of motion,and prevent joint stiffness.If the non-surgical treatment is not ideal or fails,surgical treatment is feasible.Currently,arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice.Although open Broström surgery provides good results,the modified arthroscopic Broström surgery has many advantages,such as less trauma,rapid pain relief,rapid postoperative recovery,and fewer complications,and is more popular with patients.In general,when treating acute injury to the ATFL,treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.展开更多
Methods: 68 patients with acute injury of anterior talofibular ligament were examined by high-frequency two-dimensional ultrasound combined with pressure and energy Doppler ultrasound. Among them, the changes of thick...Methods: 68 patients with acute injury of anterior talofibular ligament were examined by high-frequency two-dimensional ultrasound combined with pressure and energy Doppler ultrasound. Among them, the changes of thickness, echo, continuity, tension of anterior talofibular ligament, passive varus ligament of plantar flexion, changes of joint space, and energy Doppler during compression were mainly observed. Results: 16 cases of type III acute injury of anterior talofibular ligament, 19 cases of type II acute injury of anterior talofibular ligament and 33 cases of type I acute injury of anterior talofibular ligament were diagnosed by high-frequency two-dimensional ultrasound, among which 5 cases of type III acute injury were misdiagnosed as type II injury, 13 cases of type III acute injury of anterior talofibular ligament were diagnosed by energy Doppler under pressure, 20 cases of type III acute injury of anterior talofibular ligament, 15 cases of type II acute injury of anterior talofibular ligament and 33 cases of type I acute injury of anterior talofibular ligament were diagnosed by high-frequency two-dimensional ultrasound combined with energy Doppler under pressure, among which 1 case of type III acute injury was misdiagnosed as type II injury. Conclusion: High frequency ultrasound can diagnose and classify the acute injury of anterior talofibular ligament. High frequency ultrasound combined with pressurized energy Doppler can improve the diagnostic efficiency of type III acute injury of anterior talofibular ligament.展开更多
Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to Se...Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to September 2023 were selected as research subjects and randomly divided into the study group (18 cases) and the control group (18 cases). The control group adopted routine examination and rehabilitation training, and the study group adopted sports medicine ultrasound and rehabilitation training. The ankle function scores and daily living ability of the two groups were compared before treatment and 9 weeks after treatment. Results: There was no statistically significant difference between the study group and the control group in terms of ankle function scores and ability to perform activities of daily living before treatment (P > 0.05), but the difference was statistically significant after treatment (P < 0.05). Conclusion: Ultrasound can be used as a supplement to magnetic resonance imaging (MRI) of the ankle joint for diagnosing anterior talofibular ligament injury;ultrasound can show the location, distance, and degree of tear of the anterior talofibular ligament rupture and accurately predict muscle atrophy around the ankle joint;ultrasound combined with computed tomography (CT) can better determine the type of intra-articular fracture of the talar subtalar joint, and guide the choice of surgical timing. In addition, ultrasound can be used to determine the severity of peroneal muscle atrophy, assess the progress of early postoperative functional exercise, and guide personalized rehabilitation programs.展开更多
Purpose:To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese,and/or with demand for highly intensive sports,and/or with poo...Purpose:To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese,and/or with demand for highly intensive sports,and/or with poor-quality ligament remnants.Methods:A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament(ATFL)reconstruction with tensional remnant repair technique from January 2019 to August 2021.General data,including demographics,surgical time,and postoperative adverse events,were recorded.The American Orthopaedic Foot and Ankle Society score(AOFAS),foot and ankle ability measure(FAAM),visual analog scale(VAS),and anterior talar translation were measured preoperatively and at 6 weeks,3 months,and 2 years postoperatively.Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL.Data were analyzed using SPSS 19.0.F test was used to analyze the pre-and postoperative VAS,FAAM,and AOFAS scores.The significance was set at p<0.05.Results:There were 20 males and 10 females among the patients with a mean age of(30.71±5.81)years.The average surgical time was(40.21±8.59)min.No adverse events were observed after surgery.At 2 years postoperatively,the anterior talar translation test showed grade 0 laxity in all patients.VAS score significantly decreased from preoperatively to 6 weeks,3 months,and 2 years postoperatively(p<0.001).Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks,3 months,and 2 years postoperatively was statistically significant(p<0.001).At 3 months postoperatively,most patients(23/30)could return to their pre-injured activities of daily living status.At 2 years postoperatively,all patients were able to return to their pre-injured activities of daily living status,and almost every patient(18/19)who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal.The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL.Conclusion:The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation,and allowed early return to pre-injured activities,which could be a reliable option for patients with chronic lateral ankle instability.展开更多
目的探讨早期负重功能锻炼对距腓前韧带断裂患者术后功能及满意度的影响。方法选取2022年6月至2024年6月南昌市洪都中医院收治的60例距腓前韧带断裂患者,根据随机数字表法将其分为常规组和早期负重组,每组30例。比较两组患者手术前后的...目的探讨早期负重功能锻炼对距腓前韧带断裂患者术后功能及满意度的影响。方法选取2022年6月至2024年6月南昌市洪都中医院收治的60例距腓前韧带断裂患者,根据随机数字表法将其分为常规组和早期负重组,每组30例。比较两组患者手术前后的美国足踝外科学会踝-后足评分量表(American Orthopedic Foot and Ankle Society ankle-hindfoot scale,AOFAS-AHS)、坎伯兰踝关节不稳量表(Cumberland ankle instability tool,CAIT)、踝关节主动关节位置觉(joint position sense active,JPSA)和被动关节位置觉(joint position sense passive,JPSP)及术后满意度。结果术后6个月,两组患者的AOFAS-AHS评分、CAIT评分均显著高于本组术前,JPSA和JPSP均显著小于术前(P<0.05),早期负重组患者的AOFAS-AHS评分、CAIT评分均显著高于常规组,JPSA和JPSP均显著小于常规组(P<0.05);早期负重组患者的满意率显著高于常规组(76.6%vs.66.6%,χ^(2)=6.205,P<0.001)。结论早期负重功能锻炼可改善距腓前韧带断裂患者的术后功能,提高患者术后满意度。展开更多
文摘BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.
文摘Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL.The clinical manifestations of acute injury to the ATFL include pain,swelling,and dysfunction.At present,non-surgical treatment is the first choice for acute injury of the ATFL.The standard treatment strategy involves the“peace and love”principle.After initial treatment in the acute phase,personalized rehabilitation training programs can be followed.These may involve proprioception training,muscle training,and functional exercise to restore limb coordination and muscle strength.Static stretching and other techniques to loosen joints,acupuncture,moxibustion massage,and other traditional medical treatments can relieve pain,restore range of motion,and prevent joint stiffness.If the non-surgical treatment is not ideal or fails,surgical treatment is feasible.Currently,arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice.Although open Broström surgery provides good results,the modified arthroscopic Broström surgery has many advantages,such as less trauma,rapid pain relief,rapid postoperative recovery,and fewer complications,and is more popular with patients.In general,when treating acute injury to the ATFL,treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.
文摘Methods: 68 patients with acute injury of anterior talofibular ligament were examined by high-frequency two-dimensional ultrasound combined with pressure and energy Doppler ultrasound. Among them, the changes of thickness, echo, continuity, tension of anterior talofibular ligament, passive varus ligament of plantar flexion, changes of joint space, and energy Doppler during compression were mainly observed. Results: 16 cases of type III acute injury of anterior talofibular ligament, 19 cases of type II acute injury of anterior talofibular ligament and 33 cases of type I acute injury of anterior talofibular ligament were diagnosed by high-frequency two-dimensional ultrasound, among which 5 cases of type III acute injury were misdiagnosed as type II injury, 13 cases of type III acute injury of anterior talofibular ligament were diagnosed by energy Doppler under pressure, 20 cases of type III acute injury of anterior talofibular ligament, 15 cases of type II acute injury of anterior talofibular ligament and 33 cases of type I acute injury of anterior talofibular ligament were diagnosed by high-frequency two-dimensional ultrasound combined with energy Doppler under pressure, among which 1 case of type III acute injury was misdiagnosed as type II injury. Conclusion: High frequency ultrasound can diagnose and classify the acute injury of anterior talofibular ligament. High frequency ultrasound combined with pressurized energy Doppler can improve the diagnostic efficiency of type III acute injury of anterior talofibular ligament.
文摘Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to September 2023 were selected as research subjects and randomly divided into the study group (18 cases) and the control group (18 cases). The control group adopted routine examination and rehabilitation training, and the study group adopted sports medicine ultrasound and rehabilitation training. The ankle function scores and daily living ability of the two groups were compared before treatment and 9 weeks after treatment. Results: There was no statistically significant difference between the study group and the control group in terms of ankle function scores and ability to perform activities of daily living before treatment (P > 0.05), but the difference was statistically significant after treatment (P < 0.05). Conclusion: Ultrasound can be used as a supplement to magnetic resonance imaging (MRI) of the ankle joint for diagnosing anterior talofibular ligament injury;ultrasound can show the location, distance, and degree of tear of the anterior talofibular ligament rupture and accurately predict muscle atrophy around the ankle joint;ultrasound combined with computed tomography (CT) can better determine the type of intra-articular fracture of the talar subtalar joint, and guide the choice of surgical timing. In addition, ultrasound can be used to determine the severity of peroneal muscle atrophy, assess the progress of early postoperative functional exercise, and guide personalized rehabilitation programs.
基金This study was supported by the orthopedics special research project(Shang Antong)of Sichuan Medical Association(Grant numbers:2020SAT11)the Science and Technology Planning Project of Leshan(Grant numbers:20SZD049).
文摘Purpose:To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese,and/or with demand for highly intensive sports,and/or with poor-quality ligament remnants.Methods:A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament(ATFL)reconstruction with tensional remnant repair technique from January 2019 to August 2021.General data,including demographics,surgical time,and postoperative adverse events,were recorded.The American Orthopaedic Foot and Ankle Society score(AOFAS),foot and ankle ability measure(FAAM),visual analog scale(VAS),and anterior talar translation were measured preoperatively and at 6 weeks,3 months,and 2 years postoperatively.Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL.Data were analyzed using SPSS 19.0.F test was used to analyze the pre-and postoperative VAS,FAAM,and AOFAS scores.The significance was set at p<0.05.Results:There were 20 males and 10 females among the patients with a mean age of(30.71±5.81)years.The average surgical time was(40.21±8.59)min.No adverse events were observed after surgery.At 2 years postoperatively,the anterior talar translation test showed grade 0 laxity in all patients.VAS score significantly decreased from preoperatively to 6 weeks,3 months,and 2 years postoperatively(p<0.001).Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks,3 months,and 2 years postoperatively was statistically significant(p<0.001).At 3 months postoperatively,most patients(23/30)could return to their pre-injured activities of daily living status.At 2 years postoperatively,all patients were able to return to their pre-injured activities of daily living status,and almost every patient(18/19)who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal.The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL.Conclusion:The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation,and allowed early return to pre-injured activities,which could be a reliable option for patients with chronic lateral ankle instability.
文摘目的探讨早期负重功能锻炼对距腓前韧带断裂患者术后功能及满意度的影响。方法选取2022年6月至2024年6月南昌市洪都中医院收治的60例距腓前韧带断裂患者,根据随机数字表法将其分为常规组和早期负重组,每组30例。比较两组患者手术前后的美国足踝外科学会踝-后足评分量表(American Orthopedic Foot and Ankle Society ankle-hindfoot scale,AOFAS-AHS)、坎伯兰踝关节不稳量表(Cumberland ankle instability tool,CAIT)、踝关节主动关节位置觉(joint position sense active,JPSA)和被动关节位置觉(joint position sense passive,JPSP)及术后满意度。结果术后6个月,两组患者的AOFAS-AHS评分、CAIT评分均显著高于本组术前,JPSA和JPSP均显著小于术前(P<0.05),早期负重组患者的AOFAS-AHS评分、CAIT评分均显著高于常规组,JPSA和JPSP均显著小于常规组(P<0.05);早期负重组患者的满意率显著高于常规组(76.6%vs.66.6%,χ^(2)=6.205,P<0.001)。结论早期负重功能锻炼可改善距腓前韧带断裂患者的术后功能,提高患者术后满意度。
