Atonamic Repair With Modified Brostrom Procedure For Acute Lateral Ankle Instability Under Arthroscopic Assistance(Include AFTL & CFL & PFTL)

Objective: To explore the effective treatment of acute lateral ligament injury of the ankle,and to analyze and treat the intra-articular injury with arthroscopy.Methods: From October 2014 09 months-2016 years after arthroscopic surgery in 32 patients in our hospital with acute injury of lateral ligament of the ankle(Ottawa ankle ligament injury II degree or ankle varus stress X-ray shown talar tilt more than 15 degrees),20 cases of left ankle,right ankle in 12 cases,male 18 cases,female 14 cases,age 19-52years(mean 34 years),all the cases were acute injury history,no history of chronic ankle instability,all patients underwent ankle varus stress X-ray examination and MRI parallel careful physical examination,intraoperative use of ankle before,before entering on the road,all patients underwent ankle arthroscopy,and make corresponding treatment of ankle joint lesions,the lateral anterior malleolus below the arc incision,insertion revealed fracture of AFTL or CFL or PFTL,to repair the lateral collateral ligament by modified Brostrom method,According to different types of body,simith-nephew rivets were selected according to different types of body.After sewing the ligaments at the insertion point,neutral position was fixed and PushLock was used to strengthen the sutures.All patients were followed up for 12-24 months(mean 15 months).Ankle function assessment was performed by the American ankle surgeon Association ankle foot(AOFAS)score.The AOFAS score was used to evaluate the effect of the patients before,3 months after operation and 1 years after the operation.Results:(1)ankle pain were significantly improved after surgery in 28 patients within3 weeks after complete remission,2 months postoperative swelling and 3 cases after operation,be in the intra-articular injection of sodium hyaluronate,Qingpeng ointment inunction,washing with traditional Chinese medicine treatment in January after all relieved.(2)the stress position showed that all the patients were stable in the anterior drawer test(ADT)and the varus stress test in all patients after the operation.The manual measurement of talar tilt angle for preoperative 17.32 degrees + 3.58 degrees(range,14-19),after March 4.68 ~ + 1.34 degrees(range,3-7),after 1 years + 4.16 degrees 1.12 degrees(range,3-5).(3)the average AOFAS was improved from preoperative 42 + 18.43 points(range,31-64 points)to postoperative 82.08 March + 3.25(range,72-92)in 90.32 to 1years after operation.5.17 points(range,84-100(P)< 0.001).(4)in 32 cases,1 cases of 3lateral ligaments of all fracture,it is rare,3 days to repair all the ligament anatomy,the follow-up of 14 months,all recovered well in function,gait,flexion and extension aspects.Conclusion Arthroscopic repair of acute lateral ligaments of the ankle with improved Brostrom is an effective,safe and minimally invasive method.The ankle joint function was good in the middle and short term after the operation.