Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2010
Anatomical reconstruction of the anterior inferior tibiofibular ligament for chronic disruption of the distal tibiofibular syndesmosis.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Yasui Youichi, Takao Masato, Miyamoto Wataru, Innami Ken, Matsushita Takashi
Аннотация
PURPOSE: The purpose of this study was to investigate the clinical results of anatomical reconstruction of anterior inferior tibiofibular ligament (AITFL) for the chronic tibiofibular syndesmotic disruption after typical pronation external rotation (PER) stage 4 injury.
METHODS: Six consecutive patients with chronic syndesmotic disruption after PER stage 4 injury were surgically treated. In all six patients, preoperative CT revealed remarkable opening of only the anterior part of the distal tibiofibular joint, and all six underwent anatomical reconstruction of the AITFL using autogenous gracilis tendon after confirmation of preserved tension of the posterior inferior tibiofibular ligament through intra-operative arthroscopic examination. Clinical evaluation was made using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS)and visual analogue scale (VAS) just before reconstructive surgery and at the most recent follow-up (median: 38 months, range, 31-50).
RESULTS: Median AOFAS score improved from preoperative 53 points (range, 47-74) to postoperative 95 points (range, 90-100) (P < 0.05), and median VAS score improved from preoperative 95 points (range, 55-100) to postoperative 4 points (range, 0-14) (P < 0.05).
CONCLUSIONS: The procedure, which can achieve anatomical reconstruction of the AITFL easily, seems to be one possible treatment for chronic disruption of the distal tibiofibular syndesmosis after PER stage 4 injury including avulsion fracture of the posterior malleolus, which is most common in this type of injury.
METHODS: Six consecutive patients with chronic syndesmotic disruption after PER stage 4 injury were surgically treated. In all six patients, preoperative CT revealed remarkable opening of only the anterior part of the distal tibiofibular joint, and all six underwent anatomical reconstruction of the AITFL using autogenous gracilis tendon after confirmation of preserved tension of the posterior inferior tibiofibular ligament through intra-operative arthroscopic examination. Clinical evaluation was made using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS)and visual analogue scale (VAS) just before reconstructive surgery and at the most recent follow-up (median: 38 months, range, 31-50).
RESULTS: Median AOFAS score improved from preoperative 53 points (range, 47-74) to postoperative 95 points (range, 90-100) (P < 0.05), and median VAS score improved from preoperative 95 points (range, 55-100) to postoperative 4 points (range, 0-14) (P < 0.05).
CONCLUSIONS: The procedure, which can achieve anatomical reconstruction of the AITFL easily, seems to be one possible treatment for chronic disruption of the distal tibiofibular syndesmosis after PER stage 4 injury including avulsion fracture of the posterior malleolus, which is most common in this type of injury.
Предметные рубрики MeSH
AdultAnkle InjuriesArthroscopyBone ScrewsChronic DiseaseCombined Modality TherapyFemaleFibulaFollow-Up StudiesFracture Fixation, InternalHumansInjury Severity ScoreJoint InstabilityLigaments, ArticularMaleMiddle AgedRadiographic Image Interpretation, Computer-AssistedPlastic Surgery ProceduresRecovery of FunctionRetrospective StudiesRisk AssessmentStatistics, NonparametricTibial FracturesTomography, X-Ray ComputedTreatment OutcomeYoung Adult