三角韧带损伤诊疗进展
Progress in Diagnosis and Treatment of Triangular Ligament Injury
DOI: 10.12677/jcpm.2024.34316, PDF,   
作者: 谭士凯:吉首大学第一附属医院骨二科,湖南 吉首;朱子颜:南昌大学江西医学院,江西 南昌;张贵顺:吉首大学医学院,湖南 吉首;朱光宏*:吉首大学第一附属医院骨二科,湖南 吉首;吉首大学医学院,湖南 吉首
关键词: 三角韧带手术诊疗Triangular Ligament Operative Treatment Diagnosis and Treatment
摘要: 踝关节三角韧带也被称为踝关节内侧副韧带,起自内踝,与距骨、跟骨及足舟骨相连,是维持内踝稳定最主要的结构。目前,运动所造成的踝部骨折伴三角韧带损伤在临床上较为常见,两者同时发生概率更大。三角韧带结构相对复杂,为延缓病情进展及快速康复,应该要尽快明确诊断和治疗方式。近年来对三角韧带损伤的治疗有报道,但是尚未统一共识。本文通过相关的文献资料,对三角韧带的解剖特性、损伤机制、诊疗方法及功能康复等研究进展进行总结,旨在为三角韧带损伤的临床治疗决策提供依据。
Abstract: The triangular ligament of the ankle joint, also known as the medial collateral ligament of the ankle joint, originates from the medial malleolus and is connected to the talus, calcaneus, and talus. It is the most important structure for maintaining the stability of the medial malleolus. At present, ankle fractures accompanied by triangular ligament injuries caused by exercise are more common in clinical practice, and the probability of both occurring simultaneously is higher. The structure of the triangular ligament is relatively complex, and in order to delay the progression of the disease and achieve rapid recovery, it is necessary to clarify the diagnosis and treatment methods as soon as possible. In recent years, there have been reports on the treatment of triangular ligament injuries, but there is no unified consensus yet. This article summarizes research progress on the anatomical characteristics, injury mechanisms, diagnosis and treatment methods, and functional rehabilitation of the triangular ligament through relevant literature, aiming to provide a basis for clinical treatment decisions for triangular ligament injuries.
文章引用:谭士凯, 朱子颜, 张贵顺, 朱光宏. 三角韧带损伤诊疗进展[J]. 临床个性化医学, 2024, 3(4): 2226-2231. https://doi.org/10.12677/jcpm.2024.34316

参考文献

[1] 卞旭廷, 苟小力, 张轩, 等. 踝关节三角韧带损伤的诊治及康复研究进展[J]. 中华创伤杂志, 2022, 38(9): 840-848.
[2] 贾晓东, 陈恕发, 于腾波, 等. 韧带残端保留技术对三角纤维软骨复合体深层修复后疗效影响的初步探索[J]. 骨科临床与研究杂志, 2024, 9(5): 282-288.
[3] Loozen, L., Veljkovic, A. and Younger, A. (2023) Deltoid Ligament Injury and Repair. Journal of Orthopaedic Surgery, 31, Article 10225536231182345. [Google Scholar] [CrossRef] [PubMed]
[4] 王大鹏. 踝关节骨折伴三角韧带损伤的修复与重建研究进展[J]. 系统医学, 2023, 8(9): 189-193.
[5] 郝建源. 踝关节损伤的运动生物力学分析研究进展[J]. 当代体育科技, 2022, 12(16): 155-158.
[6] 周学武. 切开复位内固定术联合韧带修复术对踝关节骨折伴三角韧带损伤患者足踝功能的影响[J]. 生命科学仪器, 2024, 22(5): 179-181.
[7] 李雄峰, 吴猛, 管国华. 踝关节三角韧带损伤的机制和治疗[C]//中国中西医结合学会骨伤科专业委员会. 2019楚天骨科高峰论坛暨第二十六届中国中西医结合骨伤科学术年会论文集. 2019: 1.
[8] Saliba, I., Cannell, S., Valentin, E., Dagher, T., Bauer, T., Anract, P., et al. (2024) Validation of the Ankle Ligament Reconstruction-Return to Sports after Injury (ALR-RSI) Score as a Tool to Assess Psychological Readiness to Return to Sport in an Active Population after Ankle Fracture Surgery: A Cross-Sectional Study. The Journal of Foot and Ankle Surgery, 63, 295-299. [Google Scholar] [CrossRef] [PubMed]
[9] Cain, J.D. and Dalmau-Pastor, M. (2021) Anatomy of the Deltoid-Spring Ligament Complex. Foot and Ankle Clinics, 26, 237-247. [Google Scholar] [CrossRef] [PubMed]
[10] Bastias, G.F. and Filippi, J. (2020) Acute Deltoid Ligament Repair in Ankle Fractures. Foot and Ankle Clinics, 25, 597-612. [Google Scholar] [CrossRef] [PubMed]
[11] 梁晨曜, 彭小宁, 成世高. 踝关节合并三角韧带损伤的研究进展[J]. 中国医学创新, 2023, 20(2): 179-183.
[12] Alshalawi, S., Galhoum, A.E., Alrashidi, Y., Wiewiorski, M., Herrera, M., Barg, A., et al. (2018) Medial Ankle Instability. Foot and Ankle Clinics, 23, 639-657. [Google Scholar] [CrossRef] [PubMed]
[13] 李元栋, 郑诚功. 使用三维踝关节有限元模型研究三角韧带损伤对踝关节旋转不稳定性的影响[J]. 医用生物力学, 2024, 39(S1): 319.
[14] 顾龙枫, 董立明. 踝关节骨折伴急性三角韧带损伤诊疗现状概述[J]. 中华关节外科杂志(电子版), 2019, 13(3): 359-364.
[15] Jeong, M.S., Choi, Y.S., Kim, Y.J., Kim, J.S., Young, K.W. and Jung, Y.Y. (2014) Deltoid Ligament in Acute Ankle Injury: MR Imaging Analysis. Skeletal Radiology, 43, 655-663. [Google Scholar] [CrossRef] [PubMed]
[16] Schlickewei, C., Krähenbühl, N., Dekeyser, G.J., Mills, M., Priemel, M., Rammelt, S., et al. (2021) Instabile Verletzungen des Deltabandkomplexes bei Sprunggelenkfrakturen. Der Unfallchirurg, 124, 190-199. [Google Scholar] [CrossRef] [PubMed]
[17] Omodani, T. and Takahashi, K. (2023) Ultrasound Findings of the Deltoid Ligament in Patients with Acute Ankle Sprains: A Retrospective Review. Journal of Orthopaedic Science, 28, 843-848. [Google Scholar] [CrossRef] [PubMed]
[18] Li, C.C.H. and Lui, T.H. (2023) Arthroscopic Deltoid Ligament Reconstruction in Rotational Ankle Instability. Arthroscopy Techniques, 12, e1179-e1184. [Google Scholar] [CrossRef] [PubMed]
[19] Lee, S., Lin, J., Hamid, K.S. and Bohl, D.D. (2019) Deltoid Ligament Rupture in Ankle Fracture: Diagnosis and Management. Journal of the American Academy of Orthopaedic Surgeons, 27, e648-e658. [Google Scholar] [CrossRef] [PubMed]
[20] 李庭, 孙志坚. 踝关节骨折合并三角韧带损伤的治疗策略[J]. 中华医学杂志, 2019, 99(21): 1601-1603.
[21] Haynes, J.A., Gosselin, M., Cusworth, B., McCormick, J., Johnson, J. and Klein, S. (2017) The Arterial Anatomy of the Deltoid Ligament: A Cadaveric Study. Foot & Ankle International, 38, 785-790. [Google Scholar] [CrossRef] [PubMed]
[22] Baumfeld, D., Baumfeld, T., Cangussú, J., Macedo, B., Silva, T.A.A., Raduan, F., et al. (2017) Does Foot Position and Location of Measurement Influence Ankle Medial Clear Space? Foot & Ankle Specialist, 11, 32-36. [Google Scholar] [CrossRef] [PubMed]
[23] 秦大山. 踝关节骨折伴三角韧带损伤修复与不修复三角韧带损伤术后临床疗效的meta分析[D]: [硕士学位论文]. 太原: 山西医科大学, 2019.
[24] 李琪琛. 修复与不修复三角韧带对踝关节骨折伴三角韧带损伤术后临床疗效的Meta分析[D]: [硕士学位论文].太原: 山西医科大学, 2022.
[25] 黄磊. 踝关节骨折合并三角韧带损伤患者经不修复韧带与手术修复两种手术治疗后对其疼痛程度与治疗效果的分析[J]. 首都食品与医药, 2022, 29(13): 17-19.
[26] 王岩岩, 石荣剑, 俞光荣, 等. 三角韧带修复在踝关节骨折伴三角韧带损伤切开复位内固定治疗中的作用[J]. 中华解剖与临床杂志, 2023, 28(7): 442-447.
[27] 韦志坤, 邵菲, 王旭东, 等. 带线锚钉修补踝关节骨折合并三角韧带损伤的疗效[J]. 局解手术学杂志, 2024, 33(8): 713-717.
[28] 李杨, 陶天奇, 蒋逸秋, 等. 全关节镜下内夹板加强固定解剖修复三角韧带损伤的疗效分析[J]. 中华骨与关节外科杂志, 2024, 17(4): 333-339.
[29] 师红立, 刘兵, 陈金刚, 等. 带线锚钉修复三角韧带在踝关节骨折治疗中的重要性分析[J]. 医学理论与实践, 2019, 32(20): 3302-3303.
[30] 王新标, 翁荔芳, 阮原芳, 等. 锚钉修复三角韧带联合切开复位内固定术治疗踝关节骨折合并三角韧带损伤患者的效果[J]. 中外医学研究, 2023, 21(18): 1-5.
[31] Zambelli, R., Fagundes, A.O., Arêas, T.S., Baumfeld, D., Brandão, J.M.M., Castilho, R.S., et al. (2024) Ankle Arthroscopy Does Not Elevate Complication Rates in Ankle Fractures. Foot and Ankle Surgery, 30, 309-312. [Google Scholar] [CrossRef] [PubMed]
[32] Choi, S., Cho, B. and Park, K. (2016) Percutaneous Deltoid Ligament Augmentation Using Suture Tape for Medial Ankle Instability. The Journal of Foot and Ankle Surgery, 55, 1307-1311. [Google Scholar] [CrossRef] [PubMed]
[33] 沈国栋, 赖志斌, 李谓林, 等. 三角韧带解剖重建并跟骨内移截骨治疗创伤后慢性踝关节内侧不稳的疗效分析[J]. 中华创伤骨科杂志, 2023, 25(7): 562-569.
[34] 赵宏谋, 梁景棋, 张言, 等. 修复与不修复踝关节骨折合并三角韧带断裂的比较研究[J]. 中华创伤骨科杂志, 2019, 21(4): 290-295.
[35] 苏嘉, 陈鸥, 周梧节. 不同方式修复踝关节骨折合并三角韧带完全断裂的疗效比较[J]. 浙江创伤外科, 2022, 27(6): 1025-1028.
[36] 任永安, 李俊, 杨立锋, 等. 锚钉在修复踝关节骨折伴三角韧带损伤中的疗效[J]. 西部医学, 2024, 36(10): 1505-1510.
[37] 顾航宇, 蒋协远, 公茂琪, 等. 采用直接修复三角韧带和后踝固定治疗下胫腓联合分离的开放踝关节骨折脱位[J]. 骨科临床与研究杂志, 2022, 7(3): 173-179.
[38] Dabash, S., Elabd, A., Potter, E., Fernandez, I., Gerzina, C., Thabet, A.M., et al. (2019) Adding Deltoid Ligament Repair in Ankle Fracture Treatment: Is It Necessary? A Systematic Review. Foot and Ankle Surgery, 25, 714-720. [Google Scholar] [CrossRef] [PubMed]
[39] Mak, M.F., Gartner, L. and Pearce, C.J. (2013) Management of Syndesmosis Injuries in the Elite Athlete. Foot and Ankle Clinics, 18, 195-214. [Google Scholar] [CrossRef] [PubMed]
[40] 李琪琛, 韩树峰, 贾二龙, 等. 踝关节骨折伴三角韧带损伤的修复与重建[J]. 中国组织工程研究, 2022, 26(11): 1793-1798.