Tightrope在下胫腓联合不稳中的临床研究
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解放军总医院

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Clinical Study of Tightrope in the Distal Tibiofibular Syndesmosis Instability
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Chinese PLA General Hospital

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    摘要:

    目的 探讨采用Tightrope治疗由踝关节镜诊断的下胫腓联合不稳的临床疗效。方法 2017年11月-2020年03月,采用Tightrope治疗41例下胫腓联合不稳患者。本资料患者年龄18~58岁,平均年龄32.73岁。其中男性17人,女性24人,左踝21例,右踝20例,合并软骨损伤14例,不合并软骨损伤27例。BMI为17.41~33.74Kg/m2,平均24.15为Kg/m2。随访时间24~52个月,平均随访时间35.44月,患者均有明确外伤史。下胫腓联合不稳由踝关节镜明确诊断,术后平均住院日为3-5天,采用6个月的术后康复锻炼方案。术前、术后6个月、术后12个月及此后每年随访一次。随访内容包括VAS视觉模拟评分法、AOFAS踝-后足评分系统和SF-36生活质量量表调查评分,同时记录患者并发症情况。结果 术后切口均I期愈合,未出现切口感染、神经血管损伤、下肢静脉血栓形成等并发症。末次随访时,患者均恢复良好,超过术前水平。VAS视觉模拟评分法和AOFAS踝-后足评分系统术前、术后6个月、术后12个月评分具有统计学意义(P<0.05),SF-36术前、术后6个月、术后12个月及末次随访评分均有统计学意义(P<0.05)。结论 下胫腓联合不稳是踝关节损伤损伤的一种特殊类型,踝关节镜是诊断金标准,采用Tightrope治疗下胫腓联合不稳可以获得满意疗效,能促进患者踝关节更好地恢复功能。

    Abstract:

    Objective To evaluate the clinical effectiveness of Tightrope elastic fixation in the treatment of distal tibiofibular syndesmosis instability. Methods From November 2017 to March 2020, 41 patients with distal tibiofibular syndesmosis instability were treated with Tightrope elastic fixation. The patients in this study ranged in age from 18 to 58, with an average age of 32.73 years. There were 17 males and 24 females, 21 left ankles, 20 right ankles, 14 combined with cartilage injury and 27 without. BMI ranged from 17.41 to 33.74 Kg/m2, with an average of 24.15 Kg/m2. Follow-up time ranged from 14 to 42 months, with an average of 25.44 months. All patients had a clear history of trauma. The distal tibiofibular syndesmosis instability was diagnosed by ankle arthroscopy. The average postoperative hospital stay was 3-5 days, and 6 months of postoperative rehabilitation exercise program was adopted. They were followed up preoperatively, 6 months postoperatively, 12 months postoperatively, and annually thereafter. Follow-up included VAS visual analogue scale, AOFAS Ankle Hindfoot Scale and SF-36 quality of life scale. Complications were also recorded. Results All the incisions were healed in stage I, and there were no complications such as incision infection, neurovascular injury and venous thrombosis of lower limbs. At the last follow-up, the patients all recovered well, exceeding the preoperative level. The scores of VAS and AOFAS before surgery, 6 months after surgery, and 12 months after surgery were statistically significant (P < 0.05), and the scores of SF-36 before surgery, 6 months after surgery, 12 months after surgery and the last follow-up were statistically significant (P < 0.05). Conclusion The distal tibiofibular syndesmosis instability is a special type of ankle injury, and ankle arthroscopy is the gold standard for diagnosis. Tightrope can achieve satisfactory results in the treatment of the the distal tibiofibular syndesmosis instability, and can promote the recovery of the function of the patient""s ankle better.

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  • 收稿日期:2022-11-08
  • 最后修改日期:2022-11-08
  • 录用日期:2023-02-16
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