Acute Tarsal Tunnel Syndrome After Total Ankle Arthroplasty With Varus Deformity

BackgroundA 54-year-old woman presented with varus ankle arthritis, which was corrected with total ankle arthroplasty (TAA). Immediately postoperatively, she was insensate throughout the plantar foot. After seven weeks, she underwent tarsal tunnel release, and the tibial nerve was found to be intact. Plantar sensation improved by one week after exploration with neurolysis and was completely intact at one year.ConclusionLoss of plantar sensation can occur following TAA for varus arthritic deformity. One potential cause is tibial nerve compression from tightening the laciniate ligament, resulting in acute tarsal tunnel syndrome. The condition can be remedied with early recognition and tarsal tunnel release. Level of Evidence: V     

Ankle kinematics and kinetics during gait in healthy and rheumatoid arthritis post-menopausal women

Objective: In the literature, it is not clear whether rheumatoid arthritis (RA) post-menopausal women have different ankle biomechanical parameters than healthy post-menopausal women. This study aimed to compare the ankle kinematics and kinetics during the gait stance phase of RA post-menopausal women with age-matched healthy post-menopausal women.

Materials and methods: A three-dimensional motion analysis system (9 cameras; 200?Hz) synchronised with a force plate (1000?Hz) was used to assess ankle kinematics and kinetics during barefoot walking at a natural and self-selected speed. A biomechanical model was used to model body segments and joint centres (combined anthropometric measurements and the placement of 39 reflective markers). Thirty-six women (18 RA post-menopausal women and 18 age-matched healthy post-menopausal women) performed 14 valid trials (comprising seven left and seven right footsteps on a force plate). Lower limb muscle mass was evaluated by an octopolar bioimpedance analyser.

Results: RA post-menopausal women yielded a longer stance phase and controlled dorsiflexion sub-phase (p?<?0.001), higher dorsiflexion at the final controlled dorsiflexion sub-phase and lower plantar flexion at toe off (p?<?0.05), lower angular displacements (p?<?0.05), and lower ankle moment of force peak and ankle power peak (p?<?0.001). No intergroup differences were found in lower limb muscle mass.

Conclusions: RA post-menopausal women yielded changes in ankle kinematic and kinetic parameters during the gait stance phase, resulting in a lower capacity to produce ankle moment of force and ankle power during the propulsive gait phase.     

胫骨螺旋形骨折合并后踝骨折与单纯踝关节骨折的区别

目的:比较后踝骨折两种不同类型的临床区别,为后踝骨折的临床诊治提供借鉴参考依据。方法:选取2010年1月-2013年1月我院收治的成人胫腓骨骨干骨折和单纯踝关节骨折患者3578例为研究对象,对两种骨折患者的后踝骨折发生率、后踝骨折合并外踝骨折的发生率等进行比较分析。结果:(1)TAF患者的后踝骨折发生率高于单纯踝关节骨折患者的后踝骨折发生率,差异具有统计学意义(P0.05);(2)TSPMF患者的外踝骨折发生率低于单纯后踝关节骨折的外踝骨折发生率,差异具有统计学意义(P0.05)。结论:胫骨螺旋形骨折与单纯踝关节骨折存在一定程度的差异,临床实践中应针对两种骨折的临床特点实施有针对性的治疗方案。     

Hinged ankle braces do not alter knee mechanics during sidestep cutting

Lateral ankle sprains are common injuries in quick, dynamic movements and are caused by rapid ankle inversion. Ankle braces are used to reduce ankle inversion, while allowing normal plantar and dorsiflexion ranges of motion. Knee injuries, such as anterior cruciate ligament injuries, are also common in dynamic movements. It is important to understand how ankle braces affect injury risk at other proximal joints. There is limited and conflicting results on how ankle braces affect knee mechanics during these types of movements. Additionally, it is unknown if sex differences exist when using an ankle brace. Therefore, the purpose of this study was to determine the effects of a hinged ankle brace and sex during a 45° cutting movement. Three-dimensional kinematics and ground reaction forces were collected using a motion capture system and force plate on ten men and eight women during cutting trials. 2 × 2 repeated measures ANOVAs were used to detect differences in ground reaction forces, as well as knee and ankle kinematics between brace conditions and sex (p < 0.05). The brace condition exhibited greater initial contact ankle dorsiflexion (p = 0.011), decreased peak ankle inversion (p < 0.01), and increased vertical loading rate (p = 0.040). Females performed the cutting movement with less initial contact (p = 0.019) and peak knee flexion (p = 0.023) compared to males. Ankle bracing had no impact on the observed sex differences. Females exhibited decreased knee flexion compared to males, which has been well documented in the literature. The use of an ankle braces reduced ankle injury risk variables while not adversely impacting knee mechanics during a 45° sidecutting movement.     

Evaluating the Association between Anesthesia Type and Postoperative Complications for Patients Receiving Total Ankle Arthroplasty

BackgroundTotal ankle arthroplasty (TAA) is performed for ankle arthritis and there has been interest investigating which anesthetic method is the best choice in order to optimize perioperative outcomes. In this study, we compared postoperative complications after TAA for patients receiving either 1) general anesthesia alone or 2) general anesthesia plus regional anesthesia.MethodsPatients undergoing primary TAA from 2007 to 2018 were identified in a national database. Patients were stratified into 2 cohorts: general anesthesia and general anesthesia combined with regional anesthesia. In this analysis, 30-day wound, cardiac, pulmonary, renal, thromboembolic, and sepsis complications, as well mortality, postoperative transfusion, urinary tract infection, extended length of stay, and reoperation were assessed. Bivariate analyses and multivariable logistical regression were performed.ResultsOf 1,084 total patients undergoing TAA, 878 patients (81.0%) had general anesthesia and 206 (19.0%) had general anesthesia combined with regional anesthesia. Following adjustment, there were no increased risk of postoperative complications in the combined general and regional anesthesia group compared to those who only underwent general anesthesia.ConclusionCompared to general anesthesia alone, the addition of regional anesthesia to general anesthesia for TAA is not associated with increased risk of complications in the perioperative period. Level of Evidence: III     

腕踝针联合热敏灸治疗中风后肢体功能障碍效果及对生活质量的影响

摘要 目的：评价腕踝针联合热敏灸治疗中风后肢体功能障碍的效果及对患者生活质量的影响。方法：选入我院2022年6月到2023年2月收治的中风后肢体功能障碍患者60例,根据康复方案不同分为常规组和联合组,各30例,常规组予以常规药物治疗及康复训练,联合组在常规组基础上采用腕踝针联合热敏灸治疗。评价两组的临床疗效、生活质量等,并进行统计比较。结果：联合组治疗总有效率96.67%,高于常规组的70.00%（P＜0.05）;相较于治疗前,两组治疗后PAR、Hcy、D-D水平降低（P＜0.05）,而联合组降低幅度较常规组大（P＜0.05）;两组治疗前SIAS、SS-QOL得分无差异（P＞0.05）,而治疗后,联合组SIAS、SS-QOL得分高于常规组（P＜0.05）。结论：腕踝针联合热敏灸可有效提高中风后肢体功能障碍的康复效果,调节PAR、Hcy、D-D水平,改善整体功能及患者生存质量。     

Somatosensory impairments in patients with multiple sclerosis: association with dynamic postural control and upper extremity motor function

Abstract

Purpose: We planned this study to bring attention to the somatosensory impairments in patients with multiple sclerosis (PwMS) and to investigate relationship of somatosensory impairments with dynamic postural stability and upper extremity motor function.

Methods: Seven males and 23 females, 30 patients with mean EDSS 2.9 (SD = 1.4), aged between 18 and 65 years (mean = 41.43?±?14.90 years) were included in this clinical study. Light touch sensorial assessment was made with Semmes Weinstein monofilament test and proprioception by distal proprioception test. Hand strength was measured by the Jamar dynamometer, fine motor skill was examined with nine-hole peg test, functional reach test in sitting and standing position was applied. Nottingham Extended Activities of Daily Living Scale (NEADLS) was used to measure everyday activities.

Results: We found a negative and moderate correlation between FRT in standing and light touch of the middle of the heel (right: –0.515), metatarsal bone (right r: 0.453, left r: –0.426), and medial of the foot (right r: –0.462). There was a negative and moderate correlation between NEADLS and light touch of the metatarsal bone (right r: –0.564, left r: –0.472), medial of the foot (right r: –0.531, left r: –0.479), and lateral of the foot (right r: –0.526). We found a positive and moderate correlation between proprioception of the ankle (right r: 0.421 left r: 0.588) and NEADLS.

Conclusions: We found impairment in light touch and proprioception and, associations between sensorial functions and dynamic postural stability in PwMS. Also impaired sensorial functions cause dependent patients in daily living activities. In the assessment of balance and falling risk, independency in daily living activities; foot light touch and proprioception sense should be taken into account, hence it may provide guidance in planning rehabilitation programmes.

Abbreviations: MS: multiple sclerosis; PwMS: patients with multiple sclerosis; VAS: visual analogue scale; FRT: functional reach test; 9-HPT: Nine-hole peg test; EDSS: The Expanded Disability Status Scale; NEADLS: Nottingham Extended Activities of Daily Living Scale     

半伸直位髓内钉联合空心螺钉固定治疗胫骨下1/3螺旋形骨折合并后踝骨折的疗效研究

摘要 目的：探讨半伸直位髓内钉联合空心螺钉固定治疗胫骨下1/3螺旋形骨折合并后踝骨折的疗效。方法：回顾性分析2016年10月至2020年6月期间中国人民解放军陆军第七十三集团军医院收治的60例胫骨下1/3螺旋形骨折合并后踝骨折患者的临床资料,男47例,女13例,年龄18～71岁,平均（53.15±4.06）岁,致伤原因：车祸伤27例,摔伤21例,运动伤12例。根据髓内钉置钉方式不同将其分为两组,半伸直组采用半伸直位髓内钉联合空心螺钉固定（30例）,标准组采用标准髓内钉联合空心螺钉固定（30例）,所有患者术后随访1年。比较两组手术时间、术中出血量、骨折愈合时间、踝关节功能、膝关节功能、疼痛程度、并发症的差异。结果：半伸直组手术时间短于标准组（P<0.05）,两组术中出血量、骨折愈合时间比较无统计学差异（P＞0.05）。两组术后美国足踝外科协会（AOFAS）评分、Karlsson踝关节功能（KAFS）评分、美国纽约特种外科医院(HSS)评分均呈增高趋势（P<0.05）,视觉模拟评分法（VAS）评分均呈降低趋势（P<0.05）,半伸直组术后12周、术后1年VAS评分均低于标准组（P＜0.05）,HSS评分高于标准组（P＜0.05）。两组并发症发生率比较无统计学差异（P＞0.05）。结论：采用半伸直位髓内钉联合空心螺钉固定治疗胫骨下1/3螺旋形骨折合并后踝骨折患者,与标准髓内钉联合空心螺钉固定比较,安全性和促进踝关节恢复的效果相当,且手术用时更短,患者术后疼痛更轻,膝关节功能改善更明显,在治疗中更具优势。     

Does Anterior Impaction Affect Radiographic Outcomes of Pilon Fractures?

BackgroundThe outcomes of pilon fractures are multifactorial. Anterior articular impaction requires sagittal plane correction (anterior distal tibia angle (ADTA)) with articular reduction. However, there is a risk of avascular necrosis of the articular fragments and postoperative tibiotalar arthritis. The purpose of this study was to determine if the presence of anterior impaction affects radiographic alignment after definitive fixation.MethodsRetrospective cohort study of patients who underwent operative management for pilon fractures at two academic, level 1 trauma centers between September 2005-September 2016. Fractures were categorized as having anterior impaction or no anterior impaction after review of preoperative radiographic and computer tomography imaging. Patient demographics and postoperative time to union was recorded. Quality of reduction was measured using (ADTA) (degrees), lateral distal tibia angle (LDTA) (degrees), and lateral talar station (LTS) (millimeters) from postoperative radiographs. Statistical analysis compared fracture patterns with anterior impaction to those without.Results208 patients met inclusion criteria. 132 fractures (63.4%) were determined to have anterior impaction. Cohorts were similar in demographics and medical comorbidities (p>0.05). Mean ADTA, LTDA, and LTS for the anterior impaction group 83.5°, 89.7°, and 2.4mm versus 84.6°, 89.9°, and 2.0mm in the group without anterior impaction. Cohorts significantly differed in ADTA(p=0.01), but not LDTA(p=0.12) or LTS(p=0.44). No significant differences were found between cohorts with infection (>0.05), nonunion(p=0.76), unplanned reoperation(p=0.56), or amputation(p=0.34).ConclusionThis study demonstrated no significant differences in the coronal or sagittal plane alignment when comparing definitively fixed pilon fractures with and without anterior impaction. Additional studies are needed to evaluate the longterm clinical impact of failing to restore ADTA. Level of Evidence: III     

腓骨短肌腱外侧韧带重建术治疗慢性踝关节外侧不稳的临床疗效

目的:研究外侧副韧带重建手术结合关节镜检查治疗慢性踝关节外侧不稳的临床疗效。方法:选取2012年7月-2014年7月我院收治的慢性踝关节外侧不稳患者60例,随机分为研究组和对照组,每组30例。对照组患者给予保守治疗,研究组患者采取踝关节镜探查清理联合腓骨短肌腱外侧韧带重建手术进行治疗。应用美国足踝外科裸-后足功能评分系统(AOFAS)评价两组患者治疗前后的踝关节功能评分,并比较两组的优良率、复发率以及并发症的发生率。结果:两组治疗前的AOFAS功能评分比较无统计学差异(P0.05),两组治疗后的AOFAS功能评分均较治疗前显著升高,且研究组显著高于对照组,差异具体统计学意义(P0.05)。研究组的优良率为96.7%(29/30),显著高于对照组的73.3%(22/30);研究组的复发率为0.0%(0/30),显著低于对照组的13.3%(4/30);研究组并发症的发生率为3.3%(1/30),显著低于对照组的20.0%(6/30),两组比较差异均具有统计学意义(P0.05)。结论:外侧副韧带重建手术结合关节镜检查治疗慢性踝关节外侧不稳具有较好的临床疗效,且复发率较低,并发症较少。     

Ankle muscle coactivation and its relationship with ankle joint kinematics and kinetics during gait in hemiplegic patients after stroke

Introduction: Increased ankle muscle coactivation during gait is a compensation strategy for enhancing postural stability in patients after stroke. However, no previous studies have demonstrated that increased ankle muscle coactivation influenced ankle joint movements during gait in patients after stroke.

Purpose: To investigate the relationship between ankle muscle coactivation and ankle joint movements in hemiplegic patients after stroke.

Methods: Seventeen patients after stroke participated. The coactivation index (CoI) at the ankle joint was calculated separately for the first and second double support (DS1 and DS2, respectively) and single support (SS) phases on the paretic and non-paretic sides during gait using surface electromyography. Simultaneously, three-dimensional motion analysis was performed to measure the peak values of the ankle joint angle, moment, and power in the sagittal plane. Ground reaction forces (GRFs) of the anterior and posterior components and centers of pressure (COPs) trajectory ranges and velocities were also measured.

Results: The CoI during the SS phase on the paretic side was negatively related to ankle dorsiflexion angle, ankle plantarflexion moment, ankle joint power generation, and COP velocity on the paretic side. Furthermore, the CoI during the DS2 phase on both sides was negatively related to anterior GRF amplitude on each side.

Conclusion: Increased ankle muscle coactivation is related to decreased ankle joint movement during the SS phase on the paretic side to enhance joint stiffness and compensate for stance limb instability, which may be useful for patients who have paretic instability during the stance phase after stroke.     

非刚性内固定治疗踝关节骨折合并下胫腓联合损伤患者术后踝关节功能和生活质量的影响

摘要 目的：探讨非刚性内固定治疗踝关节骨折合并下胫腓联合损伤的临床疗效及对术后踝关节功能和生活质量的影响。方法：回顾性分析2015年1月至2020年6月我院收治的60例踝关节骨折合并下胫腓联合损伤患者的诊治资料。根据内固定方法的不同,将患者分为非刚性组（n=30,采用非刚性内固定治疗下胫腓联合损伤）和传统螺钉组（n=30,采用传统螺钉内固定治疗下胫腓联合损伤）。比较两组的围术期指标和完全负重所需时间、手术前后的下胫腓重叠距离（TBOL）和下胫腓间隙（TBCS）;以美国足踝外科协会（AOFAS）踝-后足评分评估两组的术后踝关节功能,以世界卫生组织生活质量测定简表（WHOQOL-BREF）评估两组的生活质量,并比较两组的术后并发症情况。结果：非刚性组的完全负重所需时间短于传统螺钉组,操作角度大于传统螺钉组（均P<0.05）。两组患者术后6周、12周和6个月的TBOL均大于术前,TBCS均小于术前（均P<0.05）,但两组术后6周、12周和6个月的TBOL和TBCS相比无明显差异（P>0.05）。非刚性组术后12周的AOFAS评分高于传统螺钉组（P<0.05）;两组术后6个月的AOFAS评分均较术后12周升高（P<0.05）,但组间比较无明显差异（P>0.05）。术后6个月,非刚性组的WHOQOL-BREF各项评分及总分均高于传统螺钉组（P<0.05）。两组并发症发生率比较无明显差异（P>0.05）。结论：非刚性与传统螺钉内固定治疗踝关节骨折合并下胫腓联合损伤的临床疗效及康复效果相当,但非刚性固定的操作更加便利,术后恢复较快,患者术后生活质量更高,可较早完全负重。     

Effects of Forefoot Shoe on Knee and Ankle Loading during Running in Male Recreational Runners

Objectives: Although overuse running injury risks for the ankle and knee are high, the effect of different shoe designs on Achilles tendon force (ATF) and Patellofemoral joint contact force (PTF) loading rates are unclear. Therefore, the primary objective of this study was to compare the ATF at the ankle and the PTF and Patellofemoral joint stress force (PP) at the knee using different running shoe designs (forefoot shoes vs. normal shoes). Methods: Fourteen healthy recreational male runners were recruited to run over a force plate under two shoe conditions (forefoot shoes vs. normal shoes). Sagittal plane ankle and knee kinematics and ground reaction forces were simultaneously recorded. Ankle joint mechanics (ankle joint angle, velocity, moment and power) and the ATF were calculated. Knee joint mechanics (knee joint angle velocity, moment and power) and the PTF and PP were also calculated. Results: No significant differences were observed in the PTF, ankle plantarflexion angle, ankle dorsiflexion power, peak vertical active force, contact time and PTF between the two shoe conditions. Compared to wearing normal shoes, wearing the forefoot shoes demonstrated that the ankle dorsiflexion angle, knee flexion velocity, ankle dorsiflexion moment extension, knee extension moment, knee extension power, knee flexion power and the peak patellofemoral contact stress were significantly reduced. However, the ankle dorsiflexion velocity, ankle plantarflexion velocity, ankle plantarflexion moment and Achilles tendons force increased significantly. Conclusions: These findings suggest that wearing forefoot shoes significantly decreases the patellofemoral joint stress by reducing the moment of knee extension, however the shoes increased the ankle plantarflexion moment and ATF force. The forefoot shoes effectively reduced the load on the patellofemoral joint during the stance phase of running. However, it is not recommended for new and novice runners and patients with Achilles tendon injuries to wear forefoot shoes.     

Influence of kinematics on the wear of a total ankle replacement

Total ankle replacement (TAR) is an alternative to fusion, replacing the degenerated joint with a mechanical motion-preserving alternative. Minimal pre-clinical testing has been reported to date and existing wear testing standards lack definition. Ankle gait is complex, therefore the aim of this study was to investigate the effect on wear of a range of different ankle gait kinematic inputs. Five Zenith (Corin Group) TARs were tested in a modified knee simulator for twelve million cycles (Mc). Different combinations of IR rotation and AP displacement were applied every 2Mc to understand the effects of the individual kinematics. Wear was assessed gravimetrically every Mc and surface profilometry undertaken after each condition. With the initial unidirectional input with no AP displacement the wear rate measured 1.2±0.6 mm³/Mc. The addition of 11° rotation and 9 mm of AP displacement caused a statistically significant increase in the wear rate to 25.8±3.1 mm³/Mc. These inputs seen a significant decrease in the surface roughness at the tibial articulation. Following polishing three displacement values were tested; 0, 4 and 9 mm with no significant difference in wear rate ranging 11.8–15.2 mm³/Mc. TAR wear rates were shown to be highly dependent on the addition of internal/external rotation within the gait profile with multidirectional kinematics proving vital in the accurate wear testing of TARs. Prior to surface polishing wear rates were significantly higher but once in a steady state the AP displacement had no significant effect on the wear.     

Patient Reported Outcomes After Conversion vs. Primary Total Hip Arthroplasty: A Propensity Matched Analysis

BackgroundConversion total hip arthroplasty (cTHA) is increasingly utilized as a salvage procedure for complications associated with fracture fixation around the hip and acetabulum and for failed hip preservation surgery. While primary THA (pTHA) has a high success rate, little is known about outcomes following conversion THA. The purpose of this study is to evaluate patient reported outcomes (PROs) and complication rates following conversion THA compared to primary THA.MethodsPatients that underwent cTHA or pTHA from 2015-2020 at a large tertiary referral academic center were retrospectively identified. THA patients were propensity matched in a 1:1 fashion by age, body mass index (BMI), and sex. Pain scores and PROMIS physical function (PF), pain interference (PI), and depression (DA) scores were compared at preoperative and final postoperative follow up timepoints using independent t-tests. Differences in complication and reoperation rates between cohorts were assessed using chi square analysis.ResultsA total of 118 THAs (59 cTHA, 59 pTHA) were included in this analysis with an average follow up of 21.3 months. cTHAs were most commonly performed following hip fracture fixation (50.8%). The conversion cohort had significantly longer lengths of stay (3.6 days vs 1.9 days, p<0.01) and greater use of revision-type implants (39.0% vs 0.0%, p<0.01) compared to pTHA. There was no significant difference in complication rates (cTHA = 15.3%, pTHA = 8.5%; p=0.26), with intraoperative fracture being the most common for both. Primary and conversion THA groups also experienced similar reoperation rates (cTHA = 5.1%, pTHA = 6.8%; p=0.70). No significant differences in PROs at final follow up were identified between groups.ConclusionPatients undergoing cTHA required increased utilization of revision hip implants and had longer lengths of stay, but had comparable complication and reoperation rates, and ultimately demonstrated similar improvements in PROMIS scores compared to a matched cohort of pTHA patients. Level of Evidence: III     

矫形鞋垫联合踝关节持续被动运动用于偏瘫型脑瘫患儿步态稳定性控制的临床研究

目的:探讨矫形鞋垫联合踝关节持续被动运动(CPM)用于偏瘫型脑瘫患儿姿势控制的临床价值。方法:选择2016年6月~2017年6月在我院康复科就诊的56例偏瘫型脑瘫患儿,随机均分成两组。对照组患儿每日行物理治疗(PT)训练,每次共30分钟,每日一次,每周五次。治疗组患儿常规物理治疗训练同对照组,并同时运用足部生物力学矫形技术及踝关节CPM治疗,每次15分钟,角度恒定为-45-45度,每天一次。两组治疗疗程为三个月。治疗结束后,比较两组患儿的儿平衡能力总有效率、GMFM(E功能区评分)、肢体运动功能、踝关节张力及踝关节活动范围的改善情况。结果:两组患儿平衡能力总有效率(显效率与有效率之和)分别为92.9%和67.9%,治疗组明显优于对照组(P0.05)。治疗组治疗后GMFM(E功能区评分比较)明显高于对照组(P0.01),患侧肢体运动功能改善、踝关节张力、踝关节活动范围改善情况均明显优于对照组(P0.05)。结论:矫形鞋垫联合踝关节CPM明显有助于偏瘫型脑瘫患儿姿势控制的治疗。     

透明质酸钠联合硫酸氨基酸葡萄糖钾胶囊对踝关节损伤患者血清骨性标志物水平及关节功能的影响

目的:探讨透明质酸钠联合硫酸氨基酸葡萄糖钾胶囊对踝关节损伤患者血清骨性标志物水平及关节功能的影响。方法:选择2015年1月至2017年1月在我院接受治疗的120例踝关节损伤患者,将其随机分为观察组和对照组,每组各60例。对照组患者采用透明质酸钠联治疗,观察组则在对照组治疗方案的基础上联合硫酸氨基酸葡萄糖钾胶囊进行治疗。检测和比较两组患者治疗前后血清骨钙素(BGP)、I型前胶原羧基端肽(PICP)、骨源性碱性磷酸酶(BALP)水平及Baird-Jackson踝关节评分的变化情况及治疗后的临床疗效。结果:治疗后,观察组的总有效率(91.67%)明显高于对照组(78.33%,P0.05)。两组患者治疗后的血清BGP、PICP、BALP水平及Baird-Jackson踝关节评分均较治疗前显著升高,且观察组明显高于对照组(P0.05)。两组治疗过程中均无明显不良反应发生。结论:透明质酸钠联合硫酸氨基酸葡萄糖钾胶囊治疗踝关节损伤患者的临床疗效显著优于单用透明质酸钠联治疗,其可有效改善血清骨性标志物水平,且利于踝关节功能的恢复。     

带线锚钉修复三角韧带损伤的效果及对患者踝关节功能的影响

目的:研究带线锚钉修复三角韧带损伤在踝关节骨折内固定治疗中的作用及对踝关节功能的影响。方法:回顾性分析2012年9月至2016年8月本院收治的72例裸关节骨折并三角韧带损伤患者并且行切开复位钢板置入内固定,及采取带线锚钉内固定方式修复三角韧带损伤视为观察组;另选取同期在本院进行踝关节骨折内固定治疗但不修复三角韧带的72例患者视为对照组。分析患者治疗前、治疗后1个月、3个月、6个月踝关节功能恢复情况,观察患侧内踝间隙和不良反应。结果:观察组在治疗后1个月、3个月、6个月的AOFAS评分显著高于对照组(P0.05)。观察组在治疗后6个月后的患侧内踝间隙显著小于对照组(P0.05)。结论:带线锚钉修复三角韧带损伤在踝关节骨折内固定治疗中,可明显降低患侧内踝间隙距离,可促进患者踝关节功能恢复,无严重不良反应,值得进一步广泛推广使用。