症状性腓骨下骨慢性踝外侧不稳定的手术治疗

Surgical management of symptomatic os subfibulare with chronic lateral ankle instability

摘要:

［目的］探讨症状性腓骨下骨导致的慢性踝外侧不稳定的 Brostr?m-Gould 术线带加强修复的临床效果。［方法］回顾性分析 2019 年 5 月—2020 年 11 月本科收治的 13 例症状性腓骨下骨导致的慢性踝外侧不稳定患者的临床资料。所有患者均采取外踝下小切口腓下骨切除、Brostr?m-Gould 术线带加强修复距腓前韧带，评价围手术期和随访结果。［结果］ 所有患者均顺利完成手术，无神经、血管、肌腱损伤等严重并发症，手术切口均一期愈合，随访（16.4±5.4）个月。与术前相比，术后 6 个月及末次随访时前抽屉试验和内翻试验显著改善 （P<0.05）；踝背伸-跖屈 ROM 和距下关节内翻-外翻 ROM 无显著变化 （P> 0.05）；VAS 评分显著减少 （P<0.05），而 AOFAS 踝-后足评分显著增加 （P<0.05）。［结论］ Brostr?m-Gould 术线带加强修复可有效治疗症状性腓骨下骨导致的慢性踝外侧不稳定。

Abstract:

[Objective] To investigate the clinical outcome of Brostr?m-Gould procedure with suture band augmentation for symptomat- ic os subfibulare accompanied with chronic lateral ankle instability. [Methods] A retrospective analysis was performed on 13 patients who were admitted to our department for symptomatic os subfibulare accompanied with chronic lateral ankle instability from May 2019 to No- vember 2020. All the patients had the anterior talofibular ligament repaired by Brostr?m-Gould procedure with anchor-suture band aug- mentation through a small incision. The perioperative and follow-up consequences were evaluated. [Results] All the patients got the opera- tion completed successfully, without serious complications such as injuries to nerve, blood vessel and tendon, the incision healed in one stage, and were followed up for (16.4±5.4) months on a mean. The anterior drawer test and varus test significantly improved at 6 months af- ter operation and at the last follow-up compared with those preoperatively (P＜0.05); however, there were no significant changes in ankle dorsal flexion-plantar flexion range of motion (ROM) and subtalar varus-valgus ROM (P＞0.05). The VAS score significantly decreased (P＜ 0.05), while the AOFAS ankle- hindfoot score significantly increased over time (P＜0.05). [Conclusion] The Brostr?m-Gould procedure with anchor-suture band augmentation does effectively treat symptomatic os subfibulare accompanied with chronic lateral ankle instability.