Abstract:

Objective　To evaluate the clinical effects of different fixation methods used for acute injury of lateral ligament of the ankle. Methods　A total of 62 patients with acute injury of lateral ligament of the ankle in the Eighth Department of Orthopaedics, Guangzhou Orthopedic Hospital from January 2022 to March 2023 were selected as the research objects, and were divided into group A (21 cases), group B (20 cases), and group C (21 cases) according to different fixation methods. In group A, there were 11 males and 10 females, aged (29.48±13.10) years. In group B, there were 13 males and 7 females, aged (28.00±13.91) years. In group C, there were 13 males and 8 females, aged (26.38±12.54) years. All the patients in the three groups were treated conservatively, group A was fixed with Ossur ankle brace, group B was fixed with elastic bandage, and group C was fixed with U-shaped resin plaster. The American Orthopedic Foot and Ankle Society (AO-FAS) ankle function scores and the swing amplitudes of center of gravity when opening and closing eyes were compared among the three groups after 1 month and 2 months of treatment. Independent sample t test, paired t test, and χ² test were used. Results　After 1 month of treatment, the total score (82.62±1.56), pain score (33.62±2.16), and functional score (38.48±3.01) of the AO-FAS in group A were higher than those in group B [(76.43±2.52), (31.25±2.71), and (35.45±2.80)] and group C [(71.52±1.48), (32.67±2.39), and (28.76±2.00)], with statistically significant differences (all P<0.001). After 1 month of treatment, the swing amplitudes of center of gravity in group A when opening and closing eyes [(60.95±8.58) mm and (96.19±7.05) mm] were lower than those in group B [(74.85±8.27) mm and (102.05±7.74) mm] and group C [(74.52±5.75) mm and (101.67±4.71) mm], with statistically significant differences (all P<0.05). After 2 months of treatment, the total score (90.26±3.62), pain score (35.43±1.46), and functional score (44.43±3.46) of the AO-FAS in group A were higher than those in group B [(83.53±4.42), (31.50±1.93), and (42.45±3.46)] and group C [(83.87±3.23), (31.67±1.46), and (42.32±2.23)], with statistically significant differences (all P<0.001). After 2 months of treatment, the swing amplitudes of center of gravity in group A when opening and closing eyes [(42.19±8.48) mm and (76.12±7.81) mm] were lower than those in group B [(54.75±8.58) mm and (81.40±7.83) mm] and group C [(54.38±5.98) mm and (81.43±4.80) mm], with statistically significant differences (all P<0.05). Conclusion　After conservative treatment of acute injury of lateral ligament of the ankle, the AO-FAS functional score and proprioception of the ankle in the brace fixation group were higher than those in the other 2 fixation method groups, which maight be related to the fixation strength of plaster was too strong, the fixation strength of elastic bandage was low, but the fixation strength of brace was adjustable.

Key words:

Ankle joint,  , Lateral collateral ligament,  , Injury,  , Conservative treatment,  , Fixation method

摘要：

目的　比较不同固定方法治疗急性踝关节外侧韧带损伤的临床疗效。方法　采取回顾性分析方法选取2022年1月至2023年3月广州市正骨医院收治的62例急性踝关节外侧韧带损伤患者作为研究对象，按固定方法不同将其分为A组（21例）、B组（20例）和C组（21例）。A组男11例，女10例，年龄（29.48±13.10）岁。B组男13例，女7例，年龄（28.00±13.91）岁。C组男13例，女8例，年龄（26.38±12.54）岁。3组患者均采取保守治疗，A组采取奥索踝关节固定支具固定，B组采取弹性绷带固定，C组采取U型树脂石膏固定。比较3组患者治疗1个月后及治疗2个月后的美国足踝外科协会（AO-FAS）踝关节功能评分及睁眼闭眼重心摆动幅度。采用独立样本t检验、配对t检验、χ²检验。结果　治疗1个月后，A组AO-FAS总分［（82.62±1.56）分］、疼痛评分［（33.62±2.16）分］、功能评分［（38.48±3.01）分］高于B组［（76.43±2.52）分、（31.25±2.71）分、（35.45±2.80）分］及C组［（71.52±1.48）分、（32.67±2.39）分、（28.76±2.00）分］，差异均有统计学意义（均P<0.001）；A组睁眼时重心摆动幅度［（60.95±8.58）mm］、闭眼时重心摆动幅度［（96.19±7.05）mm］低于B组［（74.85±8.27）mm、（102.05±7.74）mm］及C组［（74.52±5.75）mm、（101.67±4.71）mm］，差异均有统计学意义（均P<0.05）。治疗2个月后，A组AO-FAS总分（90.26±3.62）分、疼痛评分（35.43±1.46）分、功能评分（44.43±3.46）分高于B组［（83.53±4.42）分、（31.50±1.93）分、（42.45±3.46）分］及C组［（83.87±3.23）分、（31.67±1.46）分、（42.32±2.23）分］，差异均有统计学意义（均P<0.001）；A组睁眼时重心摆动幅度［（42.19±8.48）mm］、闭眼时重心摆动幅度［（76.12±7.81）mm］低于B组［（54.75±8.58）mm、（81.40±7.83）mm］及C组［（54.38±5.98）mm、（81.43±4.80）mm］，差异均有统计学意义（均P<0.05）。结论　急性踝关节外侧韧带损伤保守治疗后有多种固定方法，支具固定的AO-FAS踝关节功能评分及本体感觉均高于其他2种固定方式，这可能与石膏固定强度过大、弹性绷带固定强度不够，而支具固定强度具有可调节性相关。

关键词:

踝关节, 外侧韧带, 损伤, 保守治疗, 固定方法