| 赵根,沈阳,刘铭,等.人工LARS韧带在慢性踝关节外侧不稳定中的应用.骨科,2022,13(4): 304-308. |
| 人工LARS韧带在慢性踝关节外侧不稳定中的应用 |
| Application of Artificial LARS Ligament in Chronic Lateral Ankle Instability |
| 投稿时间：2021-09-20 |
| DOI：10.3969/j.issn.1674-8573.2022.04.004 |
| 中文关键词: LARS韧带 慢性踝关节外侧不稳 踝外侧韧带重建 |
| 英文关键词: LARS ligament Chronic lateral ankle instability Reconstruction of lateral ankle ligament |
| 基金项目:沈阳联勤保障中心自选科研项目（2020-485） |
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| 中文摘要: |
| 目的 探讨人工LARS韧带在慢性踝关节外侧不稳定中的应用疗效。方法 回顾性分析北部战区总医院骨科2018年1月至2019年12月收治的30例慢性踝关节外侧不稳病例的临床资料，均为男性，年龄为（23.1±5.3）岁（18~27岁），左踝19例，右踝11例。由同一位医生采用仰卧位全关节镜下行外踝Y形人工LARS韧带重建术。观察术后2周切口愈合情况，术前及术后12个月内翻应力位距骨倾斜角度。记录术前及末次随访时美国足踝外科医师协会（American Orthopaedic Foot and Ankle Society，AOFAS）踝与后足功能评分系统、踝关节功能Kofoed评分、疼痛视觉模拟量表（visual analogue scale，VAS）评分。术后指导病例行相关康复锻炼。结果 病人随访时间为（12.6±1.7）个月（12~24个月），全部病例踝关节切口愈合情况佳，无感染等并发症发生，术后恢复满意。AOFAS评分和Kofoed评分分别由术前（42.20±5.98）分、（66.17±3.31）分提升至术后（80.63±5.39）分、（81.60±4.35）分，VAS评分由术前（7.63±0.85）分降至术后（1.03±0.67）分，内翻应力位距骨倾斜角度由术前14.73°±1.46°缩小至术后12个月的2.83°±1.01°，差异均有统计学意义（P＜0.05）。术后各项康复锻炼均达到预期目标。结论 应用人工LARS韧带治疗慢性踝关节外侧不稳疗效满意，具有踝关节稳定性好，快速恢复运动等优点，有效避免下肢深静脉血栓形成及肌肉萎缩，值得在临床上推广。 |
| 英文摘要: |
| Objective To explore the therapeutic effect of artificial LARS ligament in chronic lateral ankle instability. Methods A retrospective analysis was done on 30 cases of chronic lateral ankle instability in the Department of Orthopedics of our hospital from January 2018 to December 2019. They were all male, aged (23.1±5.3) years (18-27 years), and there were 19 cases of left ankle and 11 cases of right ankle. The same doctor used supine total arthroscopy to reconstruct the Y-shaped artificial LARS ligament of the lateral ankle. The incision healing at 2nd week postoperatively and the inversion stress position of the talus tilt angle before and 12 months after the operation were observed. The American Orthopaedic Foot and Ankle Society (AOFAS), Kofoed score and visual analogue scale (VAS) score were recorded before operation and at the last follow-up. The patients were advised to perform relevant rehabilitation exercises after the operation. Results The ankle incisions in all cases healed well without complications such as infection. The follow-up time was (12.6±1.7) months (12-24 months). All cases recovered well after operation. The AOFAS score and Kofoed score increased from 42.20±5.98 and 66.17±3.31 before operation to 80.63±5.39 and 81.60±4.35 after operation, the VAS score decreased from preoperative (7.63±0.85) to postoperative (1.03±0.67), and the talus inclination angle of varus stress level was reduced from 14.73°±1.46° before operation to 2.83°±1.01° 12 months after operation. The difference was statistically significant (P＜0.05). All postoperative rehabilitation exercises reached the expected goals. Conclusion The application of artificial LARS ligament in the treatment of chronic lateral ankle instability has a satisfactory effect. It has advantages such as good stability of the ankle joint and rapid recovery of exercise. It can effectively avoid deep vein thrombosis and muscle atrophy of the lower limbs. It is worthy of clinical promotion. |
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