改良Karlsson术治疗踝外侧副韧带急性与慢性损伤的疗效对比

Comparison of the Therapeutic Effects of Modified Karlsson Procedure on Acute and Chronic Injuries of the Lateral Collateral Ligament of the Ankle

摘要: 目的：探讨改良Karlsson术治疗踝关节外侧副韧带急性与慢性损伤的临床疗效对比。方法：回顾性研究我院于2020年6月至2022年6月收治的75例踝外侧副韧带损伤手术患者，按照首次受伤至手术时间分为慢性损伤组36例、急性损伤组39例，两组均采用改良Karlsson术解剖修复踝关节外侧副韧带，对比手术前后影像学资料以及AOFAS、VAS及Karlsson踝关节功能评分进行评估，对比其临床疗效。结果：两组患者均获得1年以上随访，随访期间均未发生感染、神经损伤及踝关节活动障碍等并发症。末次随访时，两组患者的满意度均较高，未出现不满意或疗效差的患者，两组之间比较差异无统计学意义(P > 0.05)。两组患者的AOFAS评分、VAS评分及Karlsson评分均较术前明显改善，差异有统计学意义(P < 0.05)，相应时间节点，两组之间比较差异无统计学意义(P > 0.05)。测量两组患者的距骨倾斜角及距骨前移距离，末次随访时均较术前明显改善，差异有统计学意义(P < 0.05)，两组患者之间比较，差异无统计学意义(P > 0.05)。在相应时间节点，比较两组患者的重返日常生活比例及重返运动比例，差异无统计学意义(P > 0.05)。结论：改良Karlsson术治疗踝外侧副韧带急性与慢性损伤均可取得满意的临床疗效，且急性损伤与慢性损伤的临床疗效对比没有明显差异。

Abstract: Objective: To explore the clinical efficacy comparison of modified Karlsson procedure in the treat-ment of acute and chronic injuries to the lateral collateral ligament of the ankle. Method: A retro-spective study was conducted on 75 patients with lateral collateral ligament injury of the ankle who underwent surgery in our hospital from June 2020 to June 2022. They were divided into a chronic injury group of 36 cases and an acute injury group of 39 cases according to the time from the first injury to the surgery. Both groups used the modified Karlsson procedure for anatomical repair of the lateral collateral ligament of the ankle, Compare preoperative and postoperative imaging data, as well as AOFAS, VAS, and Karlsson ankle joint function scores, to evaluate their clinical efficacy. Result: Both groups of patients were followed up for more than 1 year, and no complications such as infection, nerve injury, or ankle joint dysfunction occurred during the follow-up period. At the last follow-up, the satisfaction of both groups of patients was high, and there were no patients who were dissatisfied or had poor efficacy. There was no statistically significant difference between the two groups (P > 0.05). The AOFAS score, VAS score, and Karlsson score of the two groups of patients were significantly improved compared to before surgery, with a statistically significant difference (P < 0.05). At the corresponding time point, there was no statistically significant difference between the two groups (P > 0.05). The talus inclination angle and talus anterior displacement distance of the two groups of patients were measured. At the last follow-up, there was a significant improve-ment compared to before surgery, and the difference was statistically significant (P < 0.05). There was no statistically significant difference between the two groups of patients (P > 0.05). At the cor-responding time nodes, there was no statistically significant difference in the proportion of patients returning to daily life and returning to exercise between the two groups (P > 0.05). Conclusion: The improved Karlsson procedure can achieve satisfactory clinical efficacy in the treatment of acute and chronic injuries to the lateral collateral ligament of the ankle, and there is no significant difference in clinical efficacy between acute and chronic injuries.