踝關節外側韌帶重建術用於矯正對物理治療等無效的慢性踝關節不穩。當韌帶鬆弛或斷裂時,會發生踝關節不穩。對於需要完全保留活動範圍的運動員,人們熟知的如Bröstrum-Gould技術等簡單的修補術,是非常理想的。
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Lateral Ankle Ligament Reconstruction
踝關節外側韌帶重建術
Overview(概述)
This procedure is performed to correct chronic ankle instability that has not responded to treatment such as physical therapy. Ankle instability occurs when ligaments are stretched or torn. A simple repair, known as the Bröstrum-Gould technique, is ideal for athletes who need to retain full range of motion.
本術式用於矯正對物理治療等無效的慢性踝關節不穩。當韌帶鬆弛或斷裂時,會發生踝關節不穩。對於需要完全保留活動範圍的運動員,人們熟知的如Bröstrum-Gould技術等簡單的修補術,是非常理想的。
Incision(切口)
A small incision is made along the outside of the ankle. The injured lateral ligament (or ligaments) are identified. This example shows a stretched anterior talofibular (ATF) and a torn calcaneofibular (CF) ligament.
在踝關節外側作一小切口。辨認受傷的韌帶。此例顯示距腓前韌帶(ATF)鬆弛和跟腓韌帶(CF)撕裂。
Repairing Stretched or Torn Ligaments(修復鬆弛或撕裂的韌帶)
If a ligament was stretched but not torn, it is cut and shortened, then the two ends are sutured together. If a ligament is torn but still attached to the fibula, the ends are repaired and sewn together.
如果韌帶只是鬆弛而未撕裂,將其切斷短縮,兩端間相互縫合。如果韌帶撕裂但仍與腓骨相連,可將兩端修復縫合在一起。
Reattaching Severely Torn Ligaments(修復嚴重撕裂的韌帶)
If the ligament was pull away from the fibula, it must be reattached. sutures can attach the ends of the ligament through a small hole drilled in the fibula. sutures can also be attached to specail anchors.
如果韌帶受拉離開腓骨,必須重新附著。通過在腓骨上鑽小孔可將韌帶的末端縫合貼附。還可以通過特殊的錨釘縫合貼附。
Stabilizing the Joint(穩定關節)
The extensor retinaculum-- a bank of tissue that across infront of the ankle joint is use to reinforce the repair. A portion of it is pulled over the repair and suture to the fibula. This also helps to limit inversion of the ankle and correct the instability within the subtalar ankle joint.
伸肌支持帶是跨過踝關節前方的一束組織,用於加強修復。將其一部分拉到修復面上方,縫合到腓骨上。這樣還有助於限制踝關節內翻,矯正距下踝關節不穩。
End of Procedure/Aftercare(手術結束和術後護理)
Incision is closed with a dissolving stitch under the skin and steri-stripes on top of the skin. Plaster splints are applied until swelling has subsided. After a few days, A short leg walking cast is supplied for 3 to 4 weeks, follow by physical therapy. Full activities can be resumed after 10 to 12 weeks.
用可吸收線縫合皮下組織,皮膚用免縫膠條關閉切口。術後數天腫脹消褪前用石膏夾板。此後3~4周使用短腿行走石膏,隨後進行物理治療。術後10~12周可恢復全部活動。
(胡佰文 譯)
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