踝关节外侧结构重建治疗踝关节外侧不稳

目的：探讨踝关节外侧结构重建在治疗慢性踝关节外侧不稳中的作用。方法：回顾分析2005年7月至2008年1月收治的13例慢性踝关节不稳患者,男10例,女3例;年龄24～45岁,平均33岁。13例均采用自体半束腓骨短肌腱解剖重建距腓前韧带和跟腓韧带（Sammarco法）,手术前后按踝关节评分系统进行评分,评分项目包括稳定性、疼痛、活动能力、X线表现。结果：13例均获随访,时间6～32个月,平均16.4个月,患者踝关节评分在稳定性、疼痛、活动能力等方面均有所改善,踝关节评分由术前的平均（43.54±7.04）分提高至术后的（73.38±4.17）分,手术前后差异有统计学意义（P〈0.01）。全部患者对手术表示满意。结论：采用半束自体腓骨短肌腱解剖重建距腓前韧带及跟腓韧带的方法治疗踝关节外侧不稳,操作便利,对于以关节不稳为主要表现的患者,疗效确切。

Ligaments reconstruction for the treatment of lateral ankle instability

Objective: To study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint. Methods: From July 2005 to January 2008,among 13 patients with chronic lateral instability of the ankle joint,10 patients were male and 3 patients were female,ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament(ATFL) and calcanea-fibular ligament(CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation,which including stability,pain,locomotor activity and X-ray films. Results: All the patients were followed up ranged from 6 to 32 months,averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability,pain and locomotor activity. The total average score increased from preoperative(43.54±7.04) to postoperative(73.38±4.17). There was significant difference between preoperative scores and postoperative scores(P<0.01). All the patients were satisfied with the results. Conclusion: Anatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.