于华强+李德权+毕前航+楚晓丰+王战友+孙英杰+张晓+殷增光

[摘要] 目的 探讨急性踝关节前外侧不稳定手术解剖修复的临床疗效。方法 方便选取2014年9月—2015年9月该院骨科门诊收治30例急性踝关节前外侧不稳定患者，男性17例，女性13例；年龄15～38岁，平均32岁。经过查体及MRI证实为踝关节前外侧不稳定，采取手术切开、锚钉解剖重建距腓前韧带的方法进行治疗。采用汉化版Cumberland Ankle Instability Tool（CAIT）不稳定问卷评分，进行术前、术后第4、12周评估。 结果 30例患者术后均得到有效随访，CAIT评分由术前的（15.63±3.38）分改善为术后4周的（20.50±2.56）分和术后12周的（29.16±0.83）分。差异有统计学意义（t=-8.006，P=0.000；t=-20.492，P=0.000）。30例患者，无严重并发症发生，术后3个月随访，效果良好。 结论 急性踝关节外侧不稳定手术解剖修复效果肯定，能避免因保守治疗失败带来的并发症。具有创伤小、恢复快、手术操作简便等优点。

[关键词] 急性；踝关节外侧不稳定；修复外科手术；带线锚钉

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2017）01（b）-0067-03

[Abstract] Objective To study the surgical treatment of anatomical repair clinical curative effect of acute lateral instability of the ankle. Methods 30 cases of patients with acute lateral instability of the ankle admitted and treated in the outpatient department of orthopaedics in our hospital from September 2014 to September 2015 were convenient selected including 17 males and 13 females， and the age was between 15 and 38， and the average age was 32， and the lateral instability of the ankle was proved by the MRI， and the treatment was conducted by the operative incision and anterior talofibular ligament reconstructed by the anchoring nail anatomy Methods， the CATT questionnaire was adopted for score， and the evaluation was conducted before operation and at 4 week and 12 week after operation. Results 30 cases of patients were effectively followed up after operation， the CAIT score was from （15.63±3.38）points before operation to （20.50±2.56）points at 4 week after operation and （29.16±0.83）points at 12 week after operation， and the difference had statistical significance（t=-8.006， P=0.000；t=-20.492， P=0.000）， and there was no severe complications and the postoperative 3-month follow-up showed that the effect was good. Conclusion The surgical treatment of anatomical repair effect of acute lateral instability of the ankle is positive， which can avoid the complications brought by the conservative treatment failure with less wound， rapid recovery and simple operation.

[Key words] Acute； Lateral instability of the ankle； Operation in the department of reconstructive surgery； Suture anchors

踝關节扭伤是常见的运动损伤，近年来随着人们运动要求的提高，发病率不断增高。以往，多数学者对急性踝关节扭伤造成的外侧不稳定主张保守治疗，大部分患者可收到良好的效果，但是部分患者经过保守治疗，效果差，最终发展成为创伤性关节炎，需要行关节融合或者踝关节置换手术治疗，给患者及社会造成极损害。有研究表明，有30%的踝关节扭伤变成慢性踝关节不稳定，78%的慢性踝关节不稳定变成踝关节骨性关节炎[1]。85%的踝关节不稳定在前外侧[2]。因此早期稳定踝关节外侧不稳定，非常重要。……