Extensor retinaculum augmentation reinforces anterior talofibular ligament repair
Extensor retinaculum augmentation reinforces anterior talofibular ligament repair
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DOI：
10.1097/01.blo.0000183737.43245.26
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发表时间：
2006-01-01
影响因子：
4.2
通讯作者：
Nunley, James A.
中科院分区：
文献类型：
--
作者：
Aydogan, Umur;Glisson, Richard R.;Nunley, James A.
距腓前韧带的修复通常与下伸肌支持带一起加强，因为它被认为加强了初级韧带的修复。额外的剥离和缝合延长了手术时间，而且并非所有的外科医生在距腓前韧带修复中常规包括下伸肌支持带增强术。为了确定是否有合理的手术基础，我们确定了下伸肌支持带增强初级距腓前韧带修复的程度。配对的一对身体踝关节在监测内翻阻力的同时控制内翻，首先切断距腓前韧带，然后单独修复一期距腓前韧带或增加下伸肌支持带。下伸肌支持带增大的踝关节在旋转5度、10度、15度、20度和25度时，对踝关节内翻的阻力更大。在两个治疗组中，距腓前韧带断裂发生在类似的内翻角度，但在增强组，初次距腓前韧带修复需要更多的扭矩才能失败。在这些踝关节负荷条件下，下伸肌支持带增强术对初次距腓前韧带修复提供了保护，表明在临床上可能有更广泛的应用。
Repair of the anterior talofibular ligament often is augmented with the inferior extensor retinaculum because it is thought to reinforce the primary ligament repair. The additional dissection and suturing extend the duration of surgery, and not all surgeons routinely include inferior extensor retinaculum augmentation in anterior talofibular ligament repairs. To determine whether there is a reasonable basis for this surgery, we ascertained the degree to which inferior extensor retinaculum augmentation reinforced the primary anterior talofibular ligament repair. Matched pairs of cadaveric ankles had controlled inversion while monitoring resistance to inversion, first with the anterior talofibular ligament sectioned, then with primary anterior talofibular ligament repair alone or with inferior extensor retinaculum augmentation. The resistance to ankle inversion was greater at 5 degrees, 10 degrees, 15 degrees, 20 degrees, and 25 degrees rotation in ankles that had inferior extensor retinaculum augmentation. Anterior talofibular ligament failure occurred at similar inversion angles in both treatment groups, but the primary anterior talofibular ligament repair required more torque to fail in the augmented group. With these ankle loading conditions, inferior extensor retinaculum augmentation provided protection to the primary anterior talofibular ligament repair, indicating that broader clinical use of augmentation may be warranted.