Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술
Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method
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Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability . Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was 15.3° preoperatively, and the difference with contralateral normal side was 10.1°. At last follow up, talar tile angle and the difference with contralateral side improved to 5.9° and 1.3° respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.
Abstract
Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability . Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was 15.3° preoperatively, and the difference with contralateral normal side was 10.1°. At last follow up, talar tile angle and the difference with contralateral side improved to 5.9° and 1.3° respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.
참고문헌 (20)
- Anderson KJ, "Operative treatment of injury to the fubular collateral ligament of the ankle", J Bone Joint Surg, 36A, pp.825~832 (1954)
- Gronmark T, "Rupture of the Lateral Ligament of the Ankle: A Controlled Clinical Trial", Injury, 11, pp.215~218 (1980)
- Karlsson J, "Reconstruction of the Lateral Ligaments of the Ankle for Chronic Lateral Instability", J Bone Joint Surg, 70, pp.581~588 (1988)
- Irrgang JJ, "Balance and proprioceptive training for rehabilitation of the lower extremity", J Sports Rehab, 3, pp.68~83 (1994)
- Verhagen RA, "Long-term follow-up of inversion trauma of the ankle", Arch Orthop Trauma Surg, 114, pp.92~96 (1995)
- Garrick JG, "The frequency of injury, mechanism of injury and etiology of ankle sprains", Am J Sports Med, 5, pp.241~242 (1977)
- Gerber JP, "Persistent disability associated with ankle sprains: A prospective examination of an athletic population", Foot Ankle Int, 19, pp.653~660 (1998)
- Karlsson J, "Lateral instability of the ankle joint", Clin Orthop Relat Res, 276, pp.253~261 (1992)
- Chen CY, "Surgical reconstruction for chronic lateral instability fo the ankle. Injury", Int J Care Injured, 35, pp.809~813 (2004)
- Coughlin MJ, "Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracils graft", Foot Ankle Int, 25, pp.231~241 (2004)
- Freeman MA, "Instability of the foot after injuries to the lateral ligament of the ankle", J Bone Joint Surg Br, 47, pp.669~677 (1965)
- Berlet GC, "Chronic lateral ankle instability", Foot Ankle Clin, 4, pp.713~728 (1999)
- Pierre RK, "A review of lateral ankle ligamentous reconstructions", Foot Ankle, 3, pp.114~123 (1982)
- Leach RE, "Secondary Reconstruction of the Lateral Ligaments of the Ankle", Clin Orthop, 160, pp.201~211 (1981)
- Bahr R, "Biomechanics of ankle ligament reconstruction. An in vitro comparison of the Brostrom repair, Watson-Jones reconstruction, and a new anatomic reconstruction techqnique", Am J Sport Med, 25, pp.424~432 (1997)
- 안재훈, "변형 Brostrom 술식을 이용한 만성 족근 관절 외측 불안정성의 치료", 대한정형외과학회지, 42(1), pp.91~97 (2007), 대한정형외과학회
- Hamilton WG, "The modified Broström procedure for lateral ankle instability", Foot Ankle, 14, pp.1~7 (1993)
- Jeon HS, "The Results of Modified Brostrom Procedure for the treatment of Chronic Lateral Ankle Instability", J Korean Soc Foot Surg, 10, pp.60~65 (2006)
- Choi WJ, "Chronic lateral ankle instability. The effect of intra-articular lesions on clinical outcome", Am J Sport Med, 36, pp.2167~2172 (2008)
- Song HH, "The modified Brostrom procedure for chronic lateral ankle instability", J Korean Soc Foot Surg, 8, pp.81~85 (2004)