解剖重建术治疗慢性踝关节外侧不稳的治疗进展
Progress in the Treatment of Chronic Lateral Ankle Instability with Anatomical Reconstruction Surgery
DOI: 10.12677/ACM.2024.141040, PDF,   
作者: 刘永辉, 李 刚, 王子豪, 王 涛*：青海大学附属医院创伤骨科，青海 西宁
关键词: 踝关节不稳；解剖重建；肌腱移植；Ankle Instability； Anatomical Reconstruction； Tendon Transplantation
摘要: 踝关节外侧扭伤是肌肉骨骼系统最常见的急性损伤，大多数踝关节扭伤经非手术治疗后可完全恢复，但20%~30%的患者会发展为慢性踝关节外侧不稳定(chronic lateral ankle instability, CLAI)。当保守治疗治疗无效时应考虑手术治疗，解剖重建术是治疗慢性踝关节外侧不稳的重要治疗手段，不同的移植物可用于重建踝关节外侧韧带，可以分为两大类，自体移植肌腱和同种异体移植肌腱，每种移植物都有其优点和缺点，但没有公认的优越性，本文旨在系统地探讨自体移植肌腱和同种异体移植肌腱在踝关节韧带手术中的应用，目的是提供最新的见解，以便在为术者提供更多的证据支持。
Abstract: Lateral ankle sprains are the most common acute injury to the musculoskeletal system. Most ankle sprains can be fully recovered after non-surgical treatment, but 20%~30% of patients will develop chronic lateral ankle instability (CLAI). When conservative treatment is ineffective, surgical treat-ment should be considered. Anatomic reconstruction is an important treatment for chronic lateral instability of the ankle joint. Different grafts can be used to reconstruct the lateral ligament of the ankle joint, which can be divided into two categories: autologous tendon transplantation and al-logeneic tendon transplantation. Each graft has its advantages and disadvantages, but there is no recognized superiority. This article aims to systematically explore the application of autologous and allogeneic tendon grafts in ankle ligament surgery, with the aim of providing the latest insights and providing more evidence support for the surgeon.
文章引用：刘永辉, 李刚, 王子豪, 王涛. 解剖重建术治疗慢性踝关节外侧不稳的治疗进展[J]. 临床医学进展, 2024, 14(1): 278-284. https://doi.org/10.12677/ACM.2024.141040

参考文献

[1] Gribble, P.A., et al. (2016) Evidence Review for the 2016 International Ankle Consortium Consensus Statement on the Prevalence, Impact and Long-Term Consequences of Lateral Ankle Sprains. British Journal of Sports Medicine, 50, 1496-1505. [Google Scholar] [CrossRef] [PubMed]
[2] Guillo, S., et al. (2013) Consensus in Chronic An-kle Instability: Aetiology, Assessment, Surgical Indications and Place for Arthroscopy. Orthopaedics & Traumatology: Surgery & Research, 99, S411-S419. [Google Scholar] [CrossRef] [PubMed]
[3] Gould, N., Seligson, D. and Gassman, J. (1980) Early and Late Repair of Lateral Ligament of the Ankle. Foot and Ankle, 1, 84-89. [Google Scholar] [CrossRef] [PubMed]
[4] Karlsson, J., Bergsten, T., Lansinger, O. and Peterson, L. (1989) Surgical Treatment of Chronic Lateral Instability of the Ankle Joint. A New Procedure. The American Journal of Sports Medicine, 17, 268-273. [Google Scholar] [CrossRef] [PubMed]
[5] Park, K.H., Lee, J.W., Suh, J.W., Shin, M.H. and Choi, W.J. (2016) Generalized Ligamentous Laxity Is an Independent Predictor of Poor Outcomes after the Modified Broström Pro-cedure for Chronic Lateral Ankle Instability. The American Journal of Sports Medicine, 44, 2975-2983. [Google Scholar] [CrossRef] [PubMed]
[6] Stewart, D.R. and Burden, S.B. (2004) Does Generalised Liga-mentous Laxity Increase Seasonal Incidence of Injuries in Male First Division Club Rugby Players? British Journal of Sports Medicine, 38, 457-460. [Google Scholar] [CrossRef] [PubMed]
[7] 刘建永. 慢性踝关节外侧不稳定距腓前韧带和跟腓韧带解剖重建[J]. 中国运动医学杂志, 2016, 35(2): 126-131.
[8] Bohnsack, M., Sürie, B., Kirsch, I.L. and Wülker, N. (2002) Biomechanical Properties of Commonly Used Autogenous Transplants in the Surgical Treatment of Chronic Lateral An-kle Instability. Foot & Ankle International, 23, 661-664. [Google Scholar] [CrossRef] [PubMed]
[9] Pagenstert, G.I., Hintermann, B. and Knupp, M. (2006) Opera-tive Management of Chronic Ankle Instability: Plantaris Graft. Foot and Ankle Clinics, 11, 567-583. [Google Scholar] [CrossRef] [PubMed]
[10] Boyer, D.S. and Younger, A.S.E. (2006) Anatomic Reconstruction of the Lateral Ligament Complex of the Ankle Using a Gracilis Autograft. Foot and Ankle Clinics, 11, 585-595. [Google Scholar] [CrossRef] [PubMed]
[11] Ibrahim, S.A.., et al. (2011) Anatomical Reconstruction of the Lateral Ligaments Using Gracillis Tendon in Chronic Ankle Instability; A New Technique. Foot and Ankle Surgery, 17, 239-246. [Google Scholar] [CrossRef] [PubMed]
[12] Coughlin, M.J., Schenck, R.C., Grebing, B.R. and Treme, G. (2004) Comprehensive Reconstruction of the Lateral Ankle for Chronic Instability Using a Free Gracilis Graft. Foot & Ankle In-ternational, 25, 231-241. [Google Scholar] [CrossRef] [PubMed]
[13] 张昊, 解冰, 薛海鹏, 等. 自体半腱肌重建外侧副韧带治疗慢性踝关节外侧不稳的疗效分析[J]. 中国骨伤, 2017, 30(6): 503-507.
[14] Paterson, R., Cohen, B., Taylor, D., Bourne, A. and Black, J. (2000) Reconstruction of the Lateral Ligaments of the Ankle Using Semi-Tendinosis Graft. Foot & Ankle International, 21, 413-419. [Google Scholar] [CrossRef] [PubMed]
[15] Xu, X., Hu, M., Liu, J., Zhu, Y. and Wang, B. (2014) Mini-mally Invasive Reconstruction of the Lateral Ankle Ligaments Using Semitendinosus Autograft or Tendon Allograft. Foot & Ankle International, 35, 1015-1021. [Google Scholar] [CrossRef] [PubMed]
[16] Okuda, R., Kinoshita, M., Morikawa, J., Jotoku, T. and Abe, M. (1999) Reconstruction for Chronic Lateral Ankle Instability Using the Palmaris Longus Tendon: Is Reconstruction of the Calcaneofibular Ligament Necessary? Foot & Ankle International, 20, 714-720. [Google Scholar] [CrossRef] [PubMed]
[17] Ahn, J.H., Choy, W.-S. and Kim, H.-Y. (2011) Reconstruction of the Lateral Ankle Ligament with a Long Extensor Tendon Graft of the Fourth Toe. The American Journal of Sports Medicine, 39, 637-644. [Google Scholar] [CrossRef] [PubMed]
[18] Takahashi, T., Nakahira, M., Kaho, K. and Kawakami, T. (2003) Anatomical Reconstruction of Chronic Lateral Ligament Injury of the Ankle Using Pedicle Tendon of the Extensor Digi-torum Longus. Archives of Orthopaedic and Trauma Surgery, 123, 175-179. [Google Scholar] [CrossRef] [PubMed]
[19] Park, C.H. and Lee, W.-C. (2017) Donor Site Morbidity after Lat-eral Ankle Ligament Reconstruction Using the Anterior Half of the Peroneus Longus Tendon Autograft. The American Journal of Sports Medicine, 45, 922-928. [Google Scholar] [CrossRef] [PubMed]
[20] Sun, Y., Wang, H., Tang, Y., Zhao, H., Qin, S. and Zhang, F. (2019) Reconstruction of the Lateral Ankle Ligaments Using the Anterior Half of Peroneus Longus Tendon Graft. Foot and Ankle Surgery, 25, 242-246. [Google Scholar] [CrossRef] [PubMed]
[21] Ventura, A., Terzaghi, C., Legnani, C. and Borgo, E. (2014) Lateral Ligament Reconstruction with Allograft in Patients with Severe Chronic Ankle Instability. Archives of Orthopaedic and Trauma Surgery, 134, 263-268. [Google Scholar] [CrossRef] [PubMed]
[22] Brambilla, L., Bianchi, A., Malerba, F., Loppini, M. and Martinelli, N. (2020) Lateral Ankle Ligament Anatomic Reconstruction for Chronic Ankle Instability: Allograft or Autograft? A Systematic Review. Foot and Ankle Surgery, 26, 85-93. [Google Scholar] [CrossRef] [PubMed]
[23] Wang, W. and Xu, G.H. (2017) Allograft Tendon Reconstruction of the Anterior Talofibular Ligament and Calcaneofibular Liga-ment in the Treatment of Chronic Ankle Instability. BMC Musculoskeletal Disorders, 18, Article No. 150. [Google Scholar] [CrossRef] [PubMed]
[24] Hua, Y., Chen, S., Jin, Y., Zhang, B., Li, Y. and Li, H. (2012) Anatomical Reconstruction of the Lateral Ligaments of the Ankle with Semitendinosus Allograft. International Ortho-paedics, 36, 2027-2031. [Google Scholar] [CrossRef] [PubMed]
[25] Ellis, S.J., Williams, B.R., Pavlov, H. and Deland, J. (2011) Re-sults of Anatomic Lateral Ankle Ligament Reconstruction with Tendon Allograft. HSS Journal, 7, 134-140. [Google Scholar] [CrossRef] [PubMed]
[26] Cordier, G., Ovigue, J., Dalmau-Pastor, M. and Michels, F. (2020) Endoscopic Anatomic Ligament Reconstruction Is a Reliable Option to Treat Chronic Lateral Ankle Instability. Knee Surgery, Sports Traumatology, Arthroscopy, 28, 86-92. [Google Scholar] [CrossRef] [PubMed]
[27] Guillo, S., Odagiri, H., van Rooij, F., Bauer, T. and Hardy, A. (2021) All-Inside Endoscopic Anatomic Reconstruction Leads to Satisfactory Functional Outcomes in Patients with Chronic Ankle Instability. Knee Surgery, Sports Traumatology, Ar-throscopy, 29, 1318-1324. [Google Scholar] [CrossRef] [PubMed]
[28] Feng, S.-M., Sun, Q.-Q., Wang, A.-G., Chang, B.-Q. and Cheng, J. (2020) Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium- and Long-Term Functional Follow-Up. Orthopaedic Surgery, 12, 505-514. [Google Scholar] [CrossRef] [PubMed]
[29] Su, T., et al. (2023) Both Open and Arthroscopic All-Inside Anatomic Re-construction with Autologous Gracilis Tendon Restore Ankle Stability in Patients with Chronic Lateral Ankle Instability. Arthroscopy, 39, 1035-1045. [Google Scholar] [CrossRef] [PubMed]
[30] Hanada, M., Hotta, K. and Matsuyama, Y. (2022) Comparison between the Simultaneous Reconstructions of the Anterior Talofibular Ligament and Calcaneofibular Ligament and the Single Reconstruction of the Anterior Talofibular Ligament for the Treatment of Chronic Lateral Ankle Instability. The Journal of Foot and Ankle Surgery, 61, 533-536. [Google Scholar] [CrossRef] [PubMed]
[31] Maffulli, N., et al. (2013) Isolated Anterior Talofibular Ligament Broström Repair for Chronic Lateral Ankle Instability: 9-Year Follow-Up. The American Journal of Sports Medicine, 41, 858-864. [Google Scholar] [CrossRef] [PubMed]
[32] 中华医学会运动医疗分会足踝专业委员会, 中国医师协会运动医学医师分会足踝学组. 慢性踝关节外侧不稳手术治疗专家共识[J]. 中华医学杂志, 2021, 101(37): 2940-2946. [Google Scholar] [CrossRef] 

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