许国泰 周姣丽 朱小华 桂景雄 邓志成 谢剑忠

【摘要】 目的：对比分析手术与非手术治疗Ⅲ度踝外侧副韧带损伤的效果与安全性，为临床上选择最佳方式治疗Ⅲ度急性踝关节外侧副韧带损伤提供必要的理论依据。方法：选取2019年3月-2020年2月收治的106例急性Ⅲ度踝外侧副韧带损伤患者，按治疗方式分为手术组和非手术组，各53例。手术组给予韧带解剖修复术，非手术组给予石膏内固定治疗。比较两组治疗后3、6、12个月临床效果、AOFAS评分及随访期间并发症发生情况。结果：治疗前，两组AOFAS评分比较，差异无统计学意义（P>0.05）;治疗后3、6、12个月，两组AOFAS评分均呈上升趋势，并且手术组治疗后3、6、12个月AOFAS评分均较非手术组上升幅度更显著（P<0.05）。治療后3、6、12个月，手术组临床优良率分别为75.47%、86.79%、96.23%，较非手术组的56.60%、75.47%、84.91%均显著提高（P<0.05）。治疗后随访12个月，两组并发症发生率比较，差异无统计学意义（P>0.05）。结论：手术治疗Ⅲ度急性踝关节外侧副韧带损伤可提高临床效果，改善患者踝关节功能，并且安全、可靠，可在临床上推广，但要把握好手术的时机，及早明确诊断。

【关键词】 石膏固定 Ⅲ度踝外侧副韧带损伤 安全性

Comparative Evaluation of the Efficacy and Safety of Surgical and Non-surgical Treatment of Ⅲ Degree Lateral Ankle Collateral Ligament Injury/XU Guotai， ZHOU Jiaoli， ZHU Xiaohua， GUI Jingxiong， DENG Zhicheng， XIE Jianzhong. //Medical Innovation of China， 2021， 18（14）： 00-005

[Abstract] Objective： To compare and analyze the efficacy and safety of surgical and non-surgical treatment of Ⅲ degree lateral ankle collateral ligament injury， and to provide the necessary theoretical basis for choosing the best clinical method for the treatment of third-degree acute lateral ankle collateral ligament injury. Method： A total of 106 patients with acute degree of malleolateral collateral ligament injury admitted to our hospital from March 2019 to February 2020 were selected， they were divided into the surgical group and non-surgical group according to the treatment methods， with 53 patients in each group. The surgical group was given anatomical ligament repair， and the non-surgical group was given plaster internal fixation. Clinical efficacy， AOFAS score at 3， 6 and 12 months after treatment and complications during follow-up were compared between the two groups. Result： Before treatment， there was no significant difference in AOFAS scores between the two groups （P>0.05）; at 3， 6 and 12 months after treatment， AOFAS scores in both groups showed an upward trend， and the increase rates of AOFAS scores in the surgical group were more significant than those in the non-surgical group （P<0.05）. At 3， 6 and 12 months after treatment， the excellent and good rates of the surgical group were 75.47%， 86.79% and 96.23%， respectively， which were significantly higher than 56.60%， 75.47% and 84.91% of the non-surgical group （P<0.05）. After 12 months of follow-up， there was no significant difference in the incidence of complications between the two groups （P>0.05）. Conclusion： Surgical treatment of Ⅲ degree of acute lateral collateral ligament injury of the ankle joint can improve the clinical effect， improve the function of the patients ankle joint， and safe， reliable， can be promoted in clinical practice， but we should grasp the timing of surgery， early diagnosis.

[Key words] Plaster fixation Ⅲ degree lateral ankle collateral ligament injury Safety

First-authors address： Xiaolan Peoples Hospital of Zhongshan， Zhongshan 528415， China

doi：10.3969/j.issn.1674-4985.2021.14.001

急性踝关节外侧副韧带损伤是临床上常见的损伤，属于运动性损伤类型，若不能及早诊断并给予有效的治疗与处理，极易导致踝关节外侧松弛，进而出现慢性踝关节不稳[1-2]。患者通常表现为踝关节反复扭伤、慢性疼痛，对踝关节的活动造成影响，增加踝关节退行性骨关节炎发生的风险[3]。近年来，急性踝关节外侧副韧带损伤的诊断、治疗引起临床上广泛重视，对于Ⅰ、Ⅱ度的急性踝关节外侧副韧带损伤主要采取非手术治疗，效果确切，对Ⅲ度急性踝关节外……