대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제14권1호
  • /
  • Pages.53-57
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  • 2010
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지

Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술

Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method

  • 이기행 (부천성모병원 정형외과) ;
  • 유종민 (서울성모병원 정형외과) ;
  • 나기태 (부천성모병원 정형외과) ;
  • 공윤배 (부천성모병원 정형외과) ;
  • 주인탁 (서울성모병원 정형외과)
  • Lee, Gi-Haeng (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital) ;
  • Yoo, Jong-Min (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital) ;
  • Na, Gee-Tae (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital) ;
  • Kong, Yoon-Bae (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital) ;
  • Chu, In-Tak (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital)
  • 투고 : 2010.04.19
  • 심사 : 2010.05.13
  • 발행 : 2010.06.15
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초록

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 $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ 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.

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참고문헌

  1. Anderson KJ, Lecocq LF. Operative treatment of injury to the fubular collateral ligament of the ankle. J Bone Joint Surg. 1954;36-A:825-32.
  2. Gronmark T, Johnsen O, Kogstad O. Rupture of the Lateral Ligament of the Ankle: A Controlled Clinical Trial. Injury. 1980;11:215-8. https://doi.org/10.1016/S0020-1383(80)80046-5
  3. Karlsson J, Bergsten T, Lansinger O, Peterson L. Reconstruction of the Lateral Ligaments of the Ankle for Chronic Lateral Instability. J Bone Joint Surg. 1988;70:581-8.
  4. lngang JJ, Whitney SL, Emily DC. Balance and proprioceptive training for rehabilitation of the lower extremity. J Sports Rehab. 1994;3:68-83.
  5. Verhagen RA, de Keizer G, van Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg. 1995;114:92-6. https://doi.org/10.1007/BF00422833
  6. Ganick JG. The frequency of injury, mechanism of injury and etiology of ankle sprains. Am J Sports Med. 1977;5:241-2. https://doi.org/10.1177/036354657700500606
  7. Gerber JP, Williams GN, Scoville CR, et al. Persistent disability associated with ankle sprains: A prospective examination of an athletic population. Foot Ankle Int. 1998;19: 653-60. https://doi.org/10.1177/107110079801901002
  8. Karlsson J, Lansinger O. Lateral instability of the ankle joint. Clin Orthop Relat Res. 1992;276:253-61.
  9. Chen CY, Huang PJ, Kao KF, et al. Surgical reconstruction for chronic lateral instability fa the ankle. Injury. Int J Care Injured. 2004;35:809-13.
  10. Coughlin MJ, Schenck RC Jr, Grebing BR, Treme G. Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracils graft. Foot Ankle Int. 2004;25: 231-41.
  11. Freeman MA. Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg Br. 1965;47:669-77.
  12. Berlet GC, Anderson RB, Davis WH. Chronic lateral ankle instability. Foot Ankle Clin. 1999;4:713-28.
  13. Pierre RK, Allman FJ, Bassett FH, Goldner JL, Fleming LL. A review of lateral ankle ligamentous reconstructions. Foot Ankle. 1982;3:114-23. https://doi.org/10.1177/107110078200300211
  14. Leach RE, Namiki Osamu, Paul GR, Stockel John. Secondary Reconstruction of the Lateral Ligaments of the Ankle. Clin Orthop.1981;160:201-11.
  15. Bahr R, Pena F, Shine J, Lew WD, Trydal S, Engebretsen L. 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. 1997;25:424-32. https://doi.org/10.1177/036354659702500402
  16. Ahn JH, Lee YG, Jung SH, Choy WS. Treatment of Chronic Ankle Lateral Instability usinig Modified Brostrom Procedure. J Korean Orthop Assoc. 2007;42:91-7. https://doi.org/10.4055/jkoa.2007.42.1.91
  17. Hamilton WG, Thompson FM, Snow WS. The modified Brostrom procedure for lateral ankle instability. Foot Ankle. 1993;14:1-7. https://doi.org/10.1177/107110079301400101
  18. Jeon HS, Jeon SJ, Kim JM, Park BM, Chang BK. The Results of Modified Brostrom Procedure for the treatment of Chronic Lateral Ankle Instability. J Korean Soc Foot Surg. 2006;10: 60-5.
  19. Choi WJ, Lee JW, Han SH, Kim BS, Lee SK. Chronic lateral ankle instability. The effect of intra-articular lesions on clinical outcome. Am J Sport Med. 2008;36:2167-72. https://doi.org/10.1177/0363546508319050
  20. Song HH, Shim DM, Lee BC, Kim DC, Cho YW, Yang JW. The modified Brostrom procedure for chronic lateral ankle instability. J Korean Soc Foot Surg. 2004;8:81-5.