文章摘要
卫文博,李伟伟.关节镜下微骨折结合带线锚钉治疗外踝韧带损伤合并距骨软骨损伤的临床疗效观察[J].安徽医药,待发表.
关节镜下微骨折结合带线锚钉治疗外踝韧带损伤合并距骨软骨损伤的临床疗效观察
投稿时间:2024-04-23  录用日期:2024-05-22
DOI:
中文关键词: 关节镜  微骨折  软骨损伤  韧带
英文关键词: 
基金项目:1.陕西省重点研发计划-社会发展领域;2. 西安市科技局创新能力强基计划-医学研究项目
作者单位邮编
卫文博 陕西省人民医院骨科 710068
李伟伟* 陕西省人民医院骨科 
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中文摘要:
      目的 评价关节镜下微骨折结合带线锚钉治疗外踝韧带损伤合并距骨软骨损伤的临床疗效。方法 回顾分析陕西省人民医院骨科2018年1月至2020年12月期间采用关节镜下微骨折结合带线锚钉治疗外踝韧带损伤合并距骨软骨损伤,并获得完整随访者48例(56踝),其中男27例,女21例;平均年龄38.2±6.7(18-54)岁;左踝22例,右踝26例,双踝8例。统计手术时间、住院时间、手术前后视觉模拟(VAS)评分、美国足踝外科踝与后足功能(AOFAS)评分、关节功能(IKDC)评分、距骨倾斜角以及距骨迁移距离,对手术前后功能状况进行评分。结果 48例(56踝)患者平均手术时间63.25±14.58min,平均住院时间 8.15±2. 11天。患者术后 VAS评分为0.89±0.13分,与术前(5.33±0.47分)比较,评分明显降低,差异有统计学意义 (P<0. 01=;患者AOFAS 评分及IKDC 评分(89.22±7.09分、93.02±3.04分)与术前(57.49±8.83分、61.95±2.76分)相比较,评分明显升高,差异有统计学意义 (P<0. 01=;距骨倾斜角由术前的9.05±1.96°降低到术后3.53±1.38°,明显得到改善;距骨迁移距离由10.19±2.83mm缩短到4.91±1.17mm,差异有统计学意义 (P<0. 01),随访期间伤口愈合不良1例,经加强换药后痊愈。结论 对外踝韧带损伤合并距骨软骨损伤患者行关节镜下微骨折结合带线锚钉治疗,可降低VAS评分,提高 AOFAS 评分及 IKDC评分,改善距骨倾斜角,疗效确切,并发症少。
英文摘要:
      Objective To evaluate the clinical efficacy of arthroscopic in microfracture combined with threaded rivets in the treatment of lateral malleolus ligament injury combined with talar cartilage injury. Methods A retrospective analysis of 48 cases (56 ankles) who received complete follow-up of the lateral malleolus ligament injury combined with talus cartilage injury by arthroscopic microfracture combined with wire rivets from January 2018 to December 2020 in the Department of Orthopedics, Shaanxi Provincial People’s Hospital, including 27 males and 21 females. The average age was 38.2±6.7 (18-54) years. There were 22 left ankles, 26 right ankles, and 8 double ankles,the injury area of talus cartilage was 1.14 ± 0.27 cm2. Recording the operation time, hospital stay, visual simulation (VAS) score before and after surgery, American Foot and Ankle Surgery Ankle and Hindfoot Function (AOFAS) score, joint function (IKDC) score, talus inclination angle and talar migration distance, and functional status before and after surgery to score. Results The average operation time of 48 patients (56 ankles) was 63.25±14.58min, and the average hospital stay was 8.15±2.11 days. The postoperative VAS score of the patient was 0.89±0.13, compared with the preoperative (5.33±0.47), and the difference was statistically significant (P<0.01=. The patient’s AOFAS score and IKDC score (89.22±7.09 and 93.02±3.04) compared with preoperative (57.49±8.83 points and 61.95±2.76 points), and the difference was statistically significant (P<0.01). the talus tilt angle was 9.05± 1.96 decreased to 3.53±1.38 postoperatively, which was significantly improved. The migration distance of the talus was shortened from 10.19±2.83mm to 4.91±1.17mm, the difference was statistically significant (P<0.01). During the follow-up period, 1 case of wound healing was poor, Healed after intensive dressing change. Conclusion Treating patients with lateral malleolus ligament injury and talar cartilage injury with arthroscopic microfracture combined with threaded rivets can shorten the operation time, hospital stay and talar migration distance, reduce the VAS score, increase the AOFAS score and IKDC score, and improve the inclination angle of the talus and have definite curative effect and less complications.
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