背景:慢性踝关节外侧不稳定(CLAI)是一种常见的疾病,使用前腓骨和跟腓骨韧带(ATFL和CFL)重建或改良Brostrom手术(MBP)治疗。然而,这些方法的比较效果没有得到很好的研究。
方法:在本研究中,我们回顾性收集了101例诊断为CLAI的患者的临床数据,这些患者接受了ATFL和CFL重建(n=51)或MBP(n=50).患者的年龄相当,性别,身体质量指数(BMI),受伤后持续时间,术前美国骨科足踝协会(AOFAS)评分,卡尔松得分,视觉模拟评分(VAS)前Talar翻译,和Talar倾斜角度。
结果:术后测量显示AOFAS评分无显著差异,卡尔松分数,和两个治疗组之间的VAS。然而,与接受MBP的患者相比,接受ATFL和CFL重建术的患者显示出显著较低的随访前距骨平移(平均=4.1667±1.3991mm)和距骨倾斜角(平均=5.0549±1.6173°).Further,与MBP(中位数=3周)相比,接受ATFL和CFL重建治疗的患者术后恢复时间(中位数=6周)明显更长.
结论:尽管这两种治疗技术在治疗CLAI方面总体有效,ATFL和CFL重建方法可以更好地控制前距骨平移和距骨倾斜角度。然而,其较长的恢复时间值得进一步研究,以优化治疗效果和恢复速度之间的平衡。
BACKGROUND: Chronic Lateral Ankle Instability (CLAI) is a common condition treated using either Anterior Talofibular and Calcaneofibular Ligament (ATFL and CFL) reconstruction or Modified Brostrom Procedure (MBP). However, the comparative efficacy of these approaches is not well-studied.
METHODS: In this study, clinical data were retrospectively collected from 101 patients diagnosed with CLAI who underwent either ATFL and CFL reconstruction (n = 51) or the MBP (n = 50). Patients were comparable in terms of age, sex, Body Mass Index (BMI), post-injury duration, preoperative American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson score, Visual Analog Score (VAS), Anterior Talar Translation, and Talar Tilt Angle.
RESULTS: The post-operative measures showed no significant differences in AOFAS Score, Karlsson Score, and VAS between both treatment groups. However, patients who underwent ATFL and CFL reconstruction showed significantly lower follow-up Anterior Talar Translation (mean = 4.1667 ± 1.3991 mm) and Talar Tilt Angle (mean = 5.0549 ± 1.6173°) compared to those who underwent MBP. Further, patients treated with ATFL and CFL reconstruction experienced a significantly longer postoperative recovery time (median = 6 weeks) compared to MBP (median = 3 weeks).
CONCLUSIONS: Although both therapeutic techniques were generally effective in treating CLAI, the ATFL and CFL reconstruction approach delivered superior control of Anterior Talar Translation and Talar Tilt Angle. However, its longer recovery time merits further study to optimize the balance between therapeutic efficacy and recovery speed.