Surgical Reconstruction for Chronic Lateral Instability of the Ankle

由於急性踝關節韌帶損傷之處理不當而導致不穩性踝關節並非少見。在本院從1987年7月到1991年12月接受踝關節外側韌帶重建手術之患者中，有45例接受追蹤檢查。其中男性28例，女性17例，平均年齡24.6歲。這些患者從首次踝關節扭傷到接受重建手術其問問隔從三個月到五年不等，平均9.6個月。所有之患者均在接受至少二個月之保守療法後症狀並無改善才行手術治療。我們採用改良的伊凡氏( Evans）方法，取用半條短腓腱作為重建的材料。這些病例追蹤平均25.1個月（由13個月至49個月不等），根據臨床檢查及症狀之評估，95.6％的患者均可得到相當的改善。但11.1％的患者不甚滿意，主要是抱怨重建後踝關節活動，尤其是內翻受限。改良式的伊凡重建術是簡單而有效之方法，但在施術時須將踝關節擺在功能位置，而非外翻位置，以免矯枉過正，造成踝關節外側太緊致使內翻動作受到限制。

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並列摘要

Chronic lateral instability of the ankle is not uncommon due to improper management of the acute ankle sprain. From July 1987 to December 1991, 45 cases of chronic lateral ankle instability that underwent surgical treatment were followed. The patients included 28 males and 17 females with an average of 24.6 y/o. The time interval from initial injury to surgery ranged from 3. months to 5 years with an average of 9.6 months. All the patients had persistent symptoms in spite of conservative treatment for at least 2 months. The method for reconstruction of the lateral stability of the ankle was the modifie4 Evans¡¦ method using part of peroneal brevis tendon. These cases were followed-up for average 25.1 months (range from 13 Ms to 49 Ms). According to Good, Jones & Livingston¡¦s criteria for clinical evaluation, 95.6% of the patients obtained excellent or good results. But 11.1% of patients were subjectively unsatisfied and complained of over tightness and limitation of foot inversion. The modified Evans¡¦ method has been proven to be easy and effective for reconstruction of the laterally unstable ankle, but it should be performed in the neutral flexion of ankle to prevent an over tight correction of lateral stability.

並列關鍵字

Ankle ； Chronic Instability ； Lateral Ligaments

國際替代計量

Surgical Reconstruction for Chronic Lateral Instability of the Ankle

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