自体半腱肌腱重建距腓前韧带和跟腓韧带治疗踝关节外侧不稳

目的探讨自体半腱肌腱重建距腓前韧带和跟腓韧带治疗踝关节外侧不稳的临床效果及安全性。方法对16例踝关节外侧不稳患者行自体半腱肌腱重建距腓前韧带和跟腓韧带手术,观察踝关节功能情况。结果患者均获得随访,时间1~3年。术后6、12个月摄踝关节内翻应力位X线片未见距骨倾斜,均未发生复发踝关节外侧不稳。术后AOFAS评分为83.52分±7.26分,明显高于术前的50.45分±4.58分。踝关节功能评定:优8例,良7例,可1例。结论自体半腱肌腱重建距腓前韧带和跟腓韧带治疗踝关节外侧不稳疗效确切,安全性高,是一种较为理想的术式。

Clinical efficacy of anatomical reconstruction of the anterior talofibular ligament and calcane-ofibular ligament with autologous semitendinosus tendon for treatment of the lateral instabili-ty of ankle joint

Objective To explore the clinical outcome of surgical treatment for the external instability of ankle joint , in which anterior talofibular and calcaniofibular ligaments were reconstructed by using the autologous semitendinosus tendon.The recovery condition of ankle joint was observed .Methods Sixteen cases of anterolateral ankle instability were treated by autologous semitendinosus anatomic reconstruction of the anterior talofibular ligament and calcaneofib -ular ligament .The ankle scoring system was used to evaluate ankle joint function before and after operation .Results All patients were followed up for 1~3 years, the ankle X-ray of varus stress was shot at 6,12 months after surgery , no cases appeared talar shift tilt ,the range of motion was generally recovered without recurrent instability during the follow-up period.The AOFAS score was obviously improved from 50.45 ±4.58 to 83.52 ±7.26.According to ankle joint fuction recovery evaluation results , there were excellent in 8 cases, good in 7, fair in 1.Conclusions The an-atomical reconstruction of the anterior talofibular ligament and calcaneofibular ligament with body semitendinosus ten -don can result in effective ankle stability , it is an ideal surgical approach .