CAJ | 학술논문

背景:以往有多种修复和重建方式来恢复踝关节外侧稳定性,但这些术式均存在一些缺陷.目的:比较改良 Karlsson 法与改良 Brostr?m 法修复慢性踝关节外侧不稳的力学变化. 方法:73例慢性踝关节外侧不稳患者,其中43例患者接受了改良 Brostr?m 手术,30例患者接受了改良 Karlsson 手术,平均随访(50.8±26.5)个月和(49.5±11.1)个月,记录软骨损伤的情况,治疗前和治疗后随访进行 AOFAS 评分、Mazur 评分、Tegner 评分、客观检查(前抽屉试验和内翻应力试验)、满意度评分和调查再伤情况. 结果与结论:所有患者中38.4%合并软骨损伤,40.5%发生在距胫关节前内侧关节面(距骨Ⅰ区和胫骨Ⅰ区).随访时两组患者 Mazur 评分、Tegner 评分均明显高于术前,组间无显著性差异.AOFAS 评分治疗后较治疗前提高的分值改良 Karlsson 组明显高于改良 Brostr?m 组.除改良 Brostr?m 组有1例治疗后阳性外,两组其他患者抽屉试验和内翻应力试验治疗后均为阴性.改良 Karlsson 组治疗时间明显短于改良 Brostr?m 组,满意度评分两组差异无显著性意义.改良 Brostr?m 组2例再伤,改良 Karlsson组1例再伤.结果表明,改良 Karlsson 治疗具有与改良 Brostr?m 治疗效果相似、操作更便捷.
배경:이왕유다충수복화중건방식래회복과관절외측은정성,단저사술식균존재일사결함.목적:비교개량 Karlsson 법여개량 Brostr?m 법수복만성과관절외측불은적역학변화. 방법:73례만성과관절외측불은환자,기중43례환자접수료개량 Brostr?m 수술,30례환자접수료개량 Karlsson 수술,평균수방(50.8±26.5)개월화(49.5±11.1)개월,기록연골손상적정황,치료전화치료후수방진행 AOFAS 평분、Mazur 평분、Tegner 평분、객관검사(전추체시험화내번응력시험)、만의도평분화조사재상정황. 결과여결론:소유환자중38.4%합병연골손상,40.5%발생재거경관절전내측관절면(거골Ⅰ구화경골Ⅰ구).수방시량조환자 Mazur 평분、Tegner 평분균명현고우술전,조간무현저성차이.AOFAS 평분치료후교치료전제고적분치개량 Karlsson 조명현고우개량 Brostr?m 조.제개량 Brostr?m 조유1례치료후양성외,량조기타환자추체시험화내번응력시험치료후균위음성.개량 Karlsson 조치료시간명현단우개량 Brostr?m 조,만의도평분량조차이무현저성의의.개량 Brostr?m 조2례재상,개량 Karlsson조1례재상.결과표명,개량 Karlsson 치료구유여개량 Brostr?m 치료효과상사、조작경편첩.
@@@@BACKGROUND: There are many repair and reconstruction methods to restore the stability of lateral ankle joint. @@@@OBJECTIVE: To compare the mechanical changes of modified Karlsson procedure and modified Brostr?m procedure for the treatment of lateral chronic ankle instability. @@@@METHODS: Seventy-three patients with lateral chronic ankle instability were enrol ed, among whom, 43 consecutive patients were treated with modified Brostr?m procedure and fol owed-up for average (50.8±26.5) months, and 30 consecutive patients underwent modified Karlsson procedure and fol owed-up for (49.5±11.1) months. Chondral lesions, American Orthopaedic Foot and Ankle Society score, Mazur score, Tegner score, satisfaction score and re-injury situation were recorded before and after treatment. Objective examinations including drawer test and inversion stress test were also done for assessment. @@@@RESULTS AND CONCLUSION: 38.4% patients had chondral lesions, and 40.5% lesions occurred in the anteromedial facet of the talocrural joint (talus zone I and tibia region I). Mazur score and Tegner score were significantly improved postoperatively in modified Brostr?m group and modified Karlsson group. There were no significant differences on Mazur score and Tegner score between two groups. The improved American Orthopaedic Foot and Ankle Society score in the modified Karlsson group was significantly higher than that in the modified Brostr?m group. The drawer test and inversion stress test were negative in two groups, except positive in one patient in modified Brostr?m group. The treatment time in the modified Karlsson group was significantly shorter than that in the modified Brostr?m group, and there was no significant difference in satisfaction score between two groups. There were two cases of re-injury in modified Brostr?m group while one case in modified Karlsson group. Modified Karlsson procedure has the treatment effect similar to modified Brostr?m procedure, but it is easier to operate.