To Explore The Clinical Effect Of Reconstructing The Anterior Talofibular Ligament With Partial Tibial Tendon

Objective:To explore the clinical effect of reconstructing the anterior talofibular ligament with partial tibial tendon to treat lateral instability of chronic ankle joint.Methods:According to the inclusion of old anterior talofibular ligament injury criteria and exclusion criteria,a retrospective analysis of 30 cases of bone and joint Department of Qingdao municipal hospital from 2016.06-2018.01 treated patients,patients aged 20-45 years old,were with chronic lateral ankle instability improved surgical treatment method that is part of the peroneus brevis tendon anatomy reconstruction of anterior talofibular ligament treatment.At 1 days before operation and after operation 3 months,6 months,12 months,respectively To examine the ipsilateral ankle activity,and X-ray examination,and according to the American Orthopaedic Foot and Ankle Society(AOFAS)ankle hindfoot score set by the National Institutes of health and the determination of clinical pain visual simulation scale(VAS)were evaluated before and after operation of ankle joint function and pain,to observe the clinical efficacy of the surgical methods before and after surgery,and the excellent rate of treatment after the surgery.Results: The AOFAS function score of the 30 patients before operation and at the last postoperative follow-up was statistically significant(P<0.05),and the degree of postoperative pain was also significantly reduced compared with that before operation.The difference was also statistically significant(P<0.05).According to the AOFAS ankle-foot function score,the recovery of ankle joint foot function after operation was excellent in 6 cases,good in 21 cases,and in 3 cases.The postoperative good rate was 90%,and the recurrence rate was 0%.Conclusions: Ankle ligament injury in mild early after conservative treatment and reasonable regular after most can be self-healing,but severe ligament injury or without special treatment,conservative treatment invalid patients often develop into chronic ankle instability disease,should adopt surgical treatment.The surgical treatment of chronic ankle instability is to reestablish the mechanical stability of the ankle joint by repairing or reconstructing the fractured ligaments and joint sac.At present,most of the reconstructionoperations have changed the normal anatomical structure of the ankle joint,especially in the anatomical mechanics.Generally,there are more operative injuries and more postoperative complications.This study found that 30 patients who failed after conservative treatment were significantly higher in AOFAS ankle foot function score than those before treatment.The difference was statistically significant(P<0.05),and postoperative pain was significantly reduced.Based on the operation mode in the modified Chrisman Snook method was further improved,using partial peroneus brevis tendon anatomy reconstruction of old anterior talofibular ligament,most improved reconstruction surgery are changed ankle anatomical structure,large incision and cons of sacrificing other tendon function,with small operation difficulty for convenience,the advantages of area,small trauma,as far as possible to reduce the damage of peroneus brevis tendon function,through the clinical verification of this operation is the treatment of chronic lateral ankle instability in a safe,operation difficulty is small,less postoperative complications,anatomical reconstruction clear curative effect.