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外侧踝关节扭伤最容易导致外侧副韧带损伤,大多数患者经保守治疗后可治愈,但仍有部分患者保守治疗失败,逐渐发展为慢性踝关节外侧不稳(CLAI),需行手术治疗。CLAI的首选治疗方式是Brost?m-Gould术,但开放式Brost?m-Gould术存在切口创伤及对关节内继发病变的诊断与处理困难等缺点。而关节镜手术创伤小、恢复快,对踝关节前外侧结构损伤小,能够处理关节内病变且术后效果与开放手术相似,被广泛应用于临床。随着关节镜技术的发展,关节镜下外侧副韧带修复术中骨性标志定位、锚钉应用、跟腓韧带及下伸肌支持带的处理等问题存在争议。本文就关节镜下外侧副韧带修复术的发展以及争议性问题进行系统综述。
Abstract：Lateral collateral ligament injury is uaually caused by lateral ankle sprain, most patients can be cured after conservative treatment. However, conservative treatment failed in some patients, and gradually develop chronic lateral ankle instability(CLAI), requiring surgical treatment. Brost?m-Gould surgery is the preferred treatment for CLAI, but Brost?m-Gould surgery in open way has shortcomings, such as wound trauma and difficulty in diagnosis and management of secondary intra-articular lesions. Arthroscopic surgery is widely used in recent years due to less trauma, faster recovery, less damage to the anterolateral structure of the ankle, which can deal with intra-articular lesions, with similar postoperative effect to that of open surgery. With the development of arthroscopic technique, there are some controversies about the positioning of bone markers, the application of anchors, and the treatment of calcaneofibular ligament and inferior extensor support band in arthroscopic lateral collateral ligament repair. In this paper, the development and controversy of lateral collateral ligament repair under arthroscopy are reviewed systematically.
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基本信息:
中图分类号:R687.4
引用信息:
[1]张恒,寿康全,杨华瑞,等.关节镜下外侧副韧带修复治疗慢性踝关节外侧不稳的研究进展[J].巴楚医学,2023,6(04):112-116.
基金信息:
湖北省卫计委西医类重点项目(No:WJ2015MA025); 湖北省自然科学基金项目(No:2021CFB488)
2023-12-30
2023-12-30