Tenodesis Versus Carbon Fiber Repair of Ankle Ligaments: A Clinical Comparison
Tenodesis Versus Carbon Fiber Repair of Ankle Ligaments: A Clinical Comparison
复制标题
踝关节韧带肌腱固定术与碳纤维修复：临床比较
DOI：
10.1097/00003086-199604000-00023
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发表时间：
1996
影响因子：
4.2
通讯作者：
L. Claes
中科院分区：
文献类型：
--
作者：
H. Becker;D. Rosenbaum;Gerhard Zeithammel†;Ralph Gnann†;G. Bauer;H. Gerngross;L. Claes
为了比较使用不同重建方法治疗慢性踝关节不稳定后的临床和功能结局，作者分别在69个月和72个月后随访了2组患者。30例患者（平均年龄28岁，范围23-39岁）接受改良Evans肌腱固定术治疗。23例患者（平均年龄32.2岁，范围22-39岁）接受了碳纤维踝关节外侧韧带全置换术。回顾性研究的方案包括问卷调查、临床检查、放射学应力诊断和使用EMED-SF系统的步态分析。与碳纤维置换术相比，肌腱固定术后背屈和内翻明显受限。尽管两组术后影像学稳定性均得到改善，但关节病的进展无法停止。肌腱固定术后，足底压力分布的测量结果显示，与对侧足相比，中足负荷增加了20%，而碳纤维置换术后发现双脚负荷对称。此外，肌腱固定术足内侧的负荷显著增加。可以得出结论，肌腱固定术和踝关节韧带解剖重建导致主观相似的结果。然而，解剖修复后对足部功能和活动范围的影响较小。
To compare the clinical and functional outcomes after using different reconstruction methods for chronic ankle instability, the authors followed 2 groups of patients after 69 and 72 months, respectively. Thirty patients (mean age, 28; range, 23-39 years) were treated with modified Evans tenodesis. Twenty-three patients (mean age, 32.2; range, 22-39 years) underwent total replacement of the lateral ankle ligaments by carbon fibers. The protocol of the retrospective study included a questionnaire, clinical examination, radiographic stress diagnostics, and gait analysis with use of the EMED-SF system. Dorsiflexion and inversion were significantly restricted after tenodesis in contrast to the carbon fiber replacement. Although radiographic stability was improved after surgery for both groups, progress of the arthrosis could not be stopped. After tenodesis, the measurement of plantar pressure distribution revealed a 20% increase of midfoot loading as compared with the opposite foot, whereas symmetrical loading of both feet was found after carbon fiber replacement. Additionally, the tenodesis feet had a significantly increased loading of the medial side of the foot. It was concluded that tenodesis and anatomic reconstruction of ankle ligaments lead to subjectively similar results. Foot function and range of motion, however, were less influenced after anatomic repair.