加强带治疗慢性外侧踝关节不稳定的应用进展

Application of the internal brace in surgical management of chronic lateral ankle instability

摘要:

踝关节扭伤是常见的运动损伤，约 20%出现慢性踝关节不稳定，需要手术治疗。本综述以“internal brace”或“lig- ament”或“加强带”和“ankle”或“踝”检索 PubMed、Embase 及中国知网，总结加强带治疗慢性外侧踝关节不稳定的生物力学、适应证、手术方法及临床效果。生物力学试验提示加强带可以显著提高重建后踝关节的即刻稳定性。部分临床研究显示单独或联合使用加强带可获得良好效果。常规切开、小切口或联合关节镜手术均可完成该手术，各有优势。加强带可能适用于全身性韧带松弛、翻修手术及较高运动需求的患者。临床应严格掌握适应证，其疗效仍需进一步研究。

Abstract:

The chronic lateral ankle instability is a common kind of sports injuries. Using the term of internal brace (IB) AND ligament OR ankle, the literatures on IB applicated in surgical management of chronic lateral ankle instability were searched in PubMed, Embase and CNKI, involving biomechanical features, suitable indications, surgical methods and clinical performance. The biomechanical tests showed that enhancement of ankle lateral ligaments with IB has good performance to resume the immediate stability. Compared with modi- fied Brostr?m procedure, the IB only or combined application of IB provided excellent clinical and radiological outcomes, especially for pa- tients with general joint laxity, revision surgery and patients who need quick return to exercise or sports. The IB should be applied in actual- ly necessary patients, whereas should not overuse it in other patients without high risk of failure.