部分腓骨短肌腱“V”双束解剖重建距腓前韧带
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陆军第八十集团军医院

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潍坊市科技发展计划项目


“V” -shaped double-bundle anatomical reconstruction of the the anterior talofibular ligament by partial peroneal brevis tendon
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The 80th Army Hospital of PLA

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    摘要:

    [目的]介绍腓骨短肌腱“V”双束解剖重建距腓前韧带(ATFL)的手术技术和初步临床效果。[方法]对23例ATFL断裂的患者取自体部分腓骨短肌腱“V”双束重建距腓前韧带,以ATFL走形为中心作弧形切口,暴露ATFL,残余韧带组织无法直接缝合,取部分腓骨短肌腱,根据ATFL走形“V”双束解剖重建,于外踝尖上1.5cm、1cm处两点重建腓骨侧止点,于距骨颈处重建距骨侧止点,两止点处尽量利用残留韧带组织加强缝合。术后分阶段按计划进行康复功能锻炼。[结果]所有患者手术顺利完成,无严重并发症。术后12个月随访结果显示,踝关节外翻与术前比较无明显差异;背伸、跖屈、内翻减小。AOFAS评分平均(91.56±2.77)分,KAF踝关节功能评分平均(90.83±2.70)分,VAS疼痛评分平均(1.74±0.93)分,较术前改善明显。[结论]腓骨短肌腱“V”双束解剖重建ATFL,更好的恢复踝关节生物力学功能,临床疗效肯定。

    Abstract:

    To introduce the surgical technique and preliminary clinical results of “V” -shaped double-bundle anatomical reconstruction of the anterior talofibular ligament(ATFL) by partial peroneal brevis tendon. With ATFL shape as the center for arc incision, the ATFL exposure, residual ligament tissue can not suture directly, part of the short fibula tendon, according to ATFL shape "V" double bundle anatomical reconstruction, at 1.5cm, 1cm reconstruction of lateral stop, in the talus neck reconstruction of lateral stop, stop point using the residual ligament tissue to strengthen the suture. Postoperative rehabilitation function exercise was carried out in stages as planned.[Method] The clinical data of 23 patients with the ATFL rupture ,All anterior talofibular ligaments were reconstructed with partial peroneal brevis tendon of “V” -shaped double-bundle。The improvement was significant over the preoperative period,with AOFAS score of (91.56 ± 2.77), KAF ankle function score of (90.83 ± 2.70), VAS pain score of (1.74 ± 0.93)。 [Conclusion] The “V” shaped double-bundle anatomical reconstruction of the ATFL by partial peroneal brevis tendon can better restore the ankle biomechanical function and has a good clinical effect.

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  • 收稿日期:2022-04-17
  • 最后修改日期:2022-11-13
  • 录用日期:2022-11-25
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