关节镜下距腓前韧带修复术治疗急性踝关节扭伤合并距骨前脱位的效果OA
Efficacy of arthroscopic anterior talofibular ligament repair for acute ankle sprain complicated by anterior talar dislocation
目的 比较关节镜下距腓前韧带修复术与石膏托固定治疗急性踝关节扭伤合并距骨前脱位的临床效果.方法 选取2023年5月—2025年10月首都医科大学附属北京朝阳医院收治的25例急性踝关节扭伤合并距骨前脱位患者为研究对象,根据治疗方式不同分为保守治疗组14例和手术治疗组11例.保守治疗组采用石膏托固定治疗,手术治疗组采用关节镜下距腓前韧带修复术治疗.比较两组患者治疗后1周及治疗后12个月疼痛视觉模拟评分法(VAS)评分、美国骨科足踝外科协会踝-后足评分(AOFAS)、足踝功能量表(FAAM)评分、踝关节前抽屉试验、踝关节MRI表现及并发症发生情况.结果 治疗后12个月,两组VAS评分较治疗后1周均显著降低(P＜0.01).治疗后12个月,两组AOFAS、FAAM评分较治疗后1周均显著升高,且手术治疗组显著高于保守治疗组(P＜0.01).手术治疗组前抽屉试验阳性率[0(0/11)]低于保守治疗组[64.29％(9/14)],距骨复位良好率[90.91％(10/11)]显著高于保守治疗组[42.86％(6/14)],三角韧带愈合良好率[81.82％(9/11)]高于保守治疗组[28.57％(4/14)],并发症发生率[0(0/11)]低于保守治疗组[35.71％(5/14)](P＜0.05).结论 关节镜下距腓前韧带修复术治疗急性踝关节扭伤合并距骨前脱位可改善踝关节稳定性和足踝功能.
Objective To compare the clinical efficacy of arthroscopic anterior talofibular ligament(ATFL)repair versus plaster splint immobilization in the treatment of acute ankle sprain complicated by anterior talar dislocation.Methods A total of 25 patients with acute ankle sprain complicated by anterior talar dislocation who were treated at Beijing Chaoyang Hospital,Capital Medical University,between May 2023 and October 2025 were enrolled.According to the treatment modality,patients were divided into a conservative treatment group(n=14)and a surgical treatment group(n=11).The conservative treatment group received plaster splint immobilization,whereas the surgical treatment group underwent arthroscopic ATFL repair.Visual Analogue Scale(VAS)scores,American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-Hindfoot Score,and Foot and Ankle Ability Measure(FAAM)scores were compared between the two groups at 1 week and 12 months after treatment.In addition,anterior drawer test results,ankle MRI findings,and the incidence of complications were evaluated.Results At 12 months after treatment,VAS scores were significantly lower than those at 1 week after treatment in both groups(P＜0.01).AOFAS and FAAM scores at 12 months after treatment were significantly higher than those at 1 week in both groups,and the scores in the surgical treatment group were significantly higher than those in the conservative treatment group(P＜0.01).The positive rate of the anterior drawer test in the surgical treatment group[0(0/11)]was lower than that in the conservative treatment group[64.29％(9/14)];the rate of satisfactory talar reduction[90.91％(10/11)]was significantly higher than that in the conservative treatment group[42.86％(6/14)];the rate of satisfactory deltoid ligament healing[81.82％(9/11)]was higher than that in the conservative treatment group[28.57％(4/14)];and the incidence of complications[0(0/11)]was lower than that in the conservative treatment group[35.71％(5/14)](P＜0.05).Conclusion Arthroscopic ATFL repair for acute ankle sprain complicated by anterior talar dislocation can effectively improve ankle stability and enhance foot and ankle function.
王克涛;陈亚平;周敬滨;曲峰;李鹏飞;黄子豪;姜鹏;果森;李韬;张霄瀚;张涛;金冰
首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200首都医科大学附属北京朝阳医院运动医学外科,北京 100200北京市顺义区医院手足外科,北京 101300北京市昌平区中西医结合医院骨科,北京 102208
急性踝关节扭伤距骨前脱位关节镜下距腓前韧带修复视觉模拟评分法足踝功能量表踝关节前抽屉试验术后并发症
acute ankle sprainanterior talar dislocationarthroscopic anterior talofibular ligament repairVisual Analogue ScaleFoot and Ankle Ability Measureankle anterior drawer testpostoperative complications
《临床误诊误治》 2026 (12)
46-52,7
国家自然科学基金青年项目(82302692)北京市自然科学基金项目(L234076)
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