CAJ | 학술논문

目的：探讨腓骨短肌腱转位修复踝关节外侧副韧带损伤及踝关节不稳的有效性。方法回顾性分析2007年7月—2013年12月收治的116例踝关节外侧副韧带损伤患者的资料，所有患者均行腓骨短肌腱转位、强生带线锚钉固定术以重建踝关节外侧副韧带，术后患者踝关节用石膏托固定于伸屈中立位，并保证轻度外翻，观察患者近期和远期疗效。结果共计随访116例，随访时间为9个月～5.5年，平均2.8年。本组患者手术切口均一期愈合；患足局部无肿痛，行走正常，踝关节主动活动及被动活动均良好；患足前抽屉试验阳性率仅为1.7％；术后触压痛和活动痛的视觉疼痛评价法（VAS）评分及关节活动度（ROM）评价指标与术前相比，经t检验统计学分析，差异具有显著性（P＜0.05）；术前美国足与踝关节协会（AOFAS）评分为（41.81+3.21）分，术后为（88.21+2.53）分。上述结果经t检验统计学分析，差异具有显著性（P＜0.05）。结论⑴踝关节外侧副韧带损伤是导致慢性踝关节不稳，甚至踝关节骨性关节炎的常见原因；⑵腓骨短肌腱转位、带线锚钉固定法是治疗踝关节外侧副韧带损伤的有效且简便的方法，对于治疗踝关节不稳、防止踝关节骨性关节炎的发生具有重要作用。
목적：탐토비골단기건전위수복과관절외측부인대손상급과관절불은적유효성。방법회고성분석2007년7월—2013년12월수치적116례과관절외측부인대손상환자적자료，소유환자균행비골단기건전위、강생대선묘정고정술이중건과관절외측부인대，술후환자과관절용석고탁고정우신굴중립위，병보증경도외번，관찰환자근기화원기료효。결과공계수방116례，수방시간위9개월～5.5년，평균2.8년。본조환자수술절구균일기유합；환족국부무종통，행주정상，과관절주동활동급피동활동균량호；환족전추체시험양성솔부위1.7％；술후촉압통화활동통적시각동통평개법（VAS）평분급관절활동도（ROM）평개지표여술전상비，경t검험통계학분석，차이구유현저성（P＜0.05）；술전미국족여과관절협회（AOFAS）평분위（41.81+3.21）분，술후위（88.21+2.53）분。상술결과경t검험통계학분석，차이구유현저성（P＜0.05）。결론⑴과관절외측부인대손상시도치만성과관절불은，심지과관절골성관절염적상견원인；⑵비골단기건전위、대선묘정고정법시치료과관절외측부인대손상적유효차간편적방법，대우치료과관절불은、방지과관절골성관절염적발생구유중요작용。
Objective To investigate the peroneus brevis tendon transposition for repairment of ankle lateral ligament damage and instability of the ankle joint. Methods A retrospective analysis from 2007 July to 2013 December treated 116 patients with ankle joint lateral collateral ligament injury data, all patients underwent peroneus brevis tendon transposition, Johnson strip anchor fixation with reconstruction of the lateral ligament of ankle joint, ankle postoperative patients with plaster fixation in flexion and neutral a mild valgus, and guarantee, and the patients were observed the effects of short-term and long-term. This group included 51 male patients, 65 female patients; age ranges from 16 to 61 years old, average 38.5 years old. Results A total of 116 patients were followed up, follow up time was 9 months to 5.5 years, average 2 years and 8 months. All patients were stage I operation incision healing; and the risk of foot and no local swelling and pain, walking normal, ankle active and passive activities are good, good ankle active and passive activities; the positive rate of foot from the anterior drawer test is only 1.7%; visual assessment of pain tenderness and pain after operation (VAS) score and range of motion (ROM) compared with the preoperative evaluation, analysis by T test statistics, with significant difference (P<0.05);preoperative USA foot & Ankle Society (AOFAS) score (41.81+3.21), postoperative (88.21+2.53), the results by T test statistical analysis, with a significant difference (P< 0.05). Conclusion (1) ankle lateral ligament injury is the result of chronic ankle instability, common cause even ankle osteoarthritis; (2) peroneus brevis tendon transposition, the belt line anchor fixing method is effective and simple treatment of ankle joint lateral collateral ligament injury, for the treatment of ankle instability to prevent the occurrence, plays an important role in osteoarthritis of the ankle.