本文選題：踝關(guān)節(jié) + 韌帶損傷��； 參考：《西安醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:比較應(yīng)用帶線錨釘結(jié)合改良Brost?m術(shù)與部分腓骨短肌腱轉(zhuǎn)位重建踝關(guān)節(jié)外側(cè)韌帶治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)的臨床療效。方法:回顧性分析2013年4月至2015年9月在西安醫(yī)學(xué)院附屬紅會醫(yī)院足踝外科診療中心進(jìn)行手術(shù)治療的39例慢性踝關(guān)節(jié)外側(cè)不穩(wěn)患者資料,其中應(yīng)用帶線錨釘結(jié)合改良Brost?m術(shù)解剖修復(fù)踝關(guān)節(jié)外側(cè)韌帶(修復(fù)組)25例,應(yīng)用部分腓骨短肌腱轉(zhuǎn)位非解剖重建踝關(guān)節(jié)外側(cè)韌帶(重建組)14例,術(shù)后定期隨訪,記錄兩組患者的手術(shù)時間、傷口愈合時間以及并發(fā)癥�；颊咝g(shù)前與術(shù)后隨訪時均按照美國足踝外科協(xié)會(AOFAS)踝與后足評分標(biāo)準(zhǔn)、完全負(fù)重行走時的踝關(guān)節(jié)疼痛視覺模擬評分(VAS)以及Karlsson踝關(guān)節(jié)功能評分評估手術(shù)療效。結(jié)果:平均手術(shù)時間重建組(78.5±9.1)min長于修復(fù)組(63.1±12.2)min,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。修復(fù)組23例獲得隨訪,2例失訪,隨訪時間12~41個月,平均(31.8±5.3)個月。重建組14例全部獲得隨訪,隨訪時間12~38個月,平均(29.3±6.2)個月。平均AOFAS踝與后足評分,修復(fù)組術(shù)前(68.78±9.10)分,末次隨訪(88.35±9.74)分;重建組術(shù)前(68.50±9.16)分,術(shù)后(85.10±8.81)分。完全負(fù)重行走時踝關(guān)節(jié)平均VAS評分,修復(fù)組術(shù)前(5.55±0.97)分,末次隨訪(2.36±2.08)分;重建組術(shù)前(5.35±1.28)分,末次隨訪(2.66±1.94)分。平均Karlsson踝關(guān)節(jié)功能評分,修復(fù)組術(shù)前(59.09±14.67)分,末次隨訪(85.17±14.00)分;重建組術(shù)前(62.36±14.41)分,末次隨訪(83.07±16.44)分。各評價數(shù)據(jù)兩組之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),同組內(nèi)末次隨訪時與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:應(yīng)用帶線錨釘結(jié)合改良Brost?m術(shù)解剖修復(fù)踝關(guān)節(jié)外側(cè)韌帶與部分腓骨短肌腱轉(zhuǎn)位非解剖重建踝關(guān)節(jié)外側(cè)韌帶對治療慢性踝關(guān)節(jié)外側(cè)不穩(wěn)均能取得良好的臨床療效,二者無顯著差異。
[Abstract]:Objective: to compare the clinical effect of modified Brost?m with wire anchor nail and partial peroneal short tendon transposition in reconstruction of lateral ligament of ankle joint in the treatment of chronic lateral ankle instability. Methods: from April 2013 to September 2015, 39 patients with chronic lateral ankle instability were analyzed retrospectively who underwent surgical treatment in the Department of foot and ankle surgery, affiliated Honghui Hospital, Xi'an Medical College. Among them, the lateral ankle ligament was repaired with wire anchor nail and modified Brost?m technique (25 cases in the repair group and 14 cases in the reconstruction group by transposition of peroneal brevis tendon (14 cases). The operative time, wound healing time and complications were recorded. Preoperative and postoperative follow-up were performed according to the American Association of foot and ankle Surgical Association (Aofas) ankle and hind foot score, complete weight-bearing walking visual analogue score (VASS) and Karlsson ankle function score. Results: the mean operation time of reconstruction group was 78.5 鹵9.1)min longer than that of repair group (63.1 鹵12.2 min). The difference was statistically significant (P 0.05). In the repair group, 2 cases were followed up for 12 ~ 41 months, with an average of 31.8 鹵5.3 months. All the 14 cases in the reconstruction group were followed up for 12 ~ 38 months with an average of 29.3 鹵6.2 months. The average AOFAS scores of ankle and hind foot were 68.78 鹵9.10 before operation, 88.35 鹵9.74 at the last follow-up in the repair group, and 68.50 鹵9.16 before operation in the reconstruction group, and 85.10 鹵8.81 in the reconstruction group. The average VAS score of ankle joint was 5.55 鹵0.97 before operation, 2.36 鹵2.08 at the last follow-up in the repair group, and 5.35 鹵1.28 before operation in the reconstruction group, and 2.66 鹵1.94 at the last follow-up in the reconstruction group. The average Karlsson ankle function score was 59.09 鹵14.67 before operation and 85.17 鹵14.00 at the last follow-up in the repair group, while in the reconstruction group it was 62.36 鹵14.41 before operation and 83.07 鹵16.44 at the last follow-up. There was no significant difference between the two groups in the evaluation data (P 0.05), but there was significant difference between the two groups at the last follow-up in the same group (P 0.05). Conclusion: the reconstruction of lateral ankle ligament with thread anchor nail combined with modified Brost?m anatomical repair of lateral ankle ligament and partial fibula short tendon transposition can achieve good clinical effect in the treatment of chronic lateral ankle instability. There was no significant difference between them.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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本文編號：1865116