Objective: To retrospectively evaluate the therapeutic effect and influencing factors of the modified Karlsson operation (anchor method) in treating chronic rupture of the calcaneofibular ligament (CFL). Methods: From August 2010 to May 2014, the data of 24 patients with calcaneofibular ligament rupture treated in Institute of Sports Medicine, Third Hospital of Peking University were retrospectively analyzed. All cases were repaired with modified Karlsson operation (anchor method). There were 14 males and 10 females, with an average age of (30±9) years, and the average body mass index (BMI) was (25±5) kg/m(2). Visual analogue pain score (VAS), American Foot and Ankle Surgery Association score (AOFAS), Tegner knee motion score, ankle stability and mobility were followed up and analyzed. The paired t test was used to compare the normal distribution data before and after the operation. Results: The average follow-up time was (41±13) months. Compared with pre-operation, VAS score decreased significantly at the last follow-up [0(0,7) vs 5(0,8), Z=4.13,P=0.000], AOFAS score increased significantly (94±10 vs 70±14, t=8.94, P<0.05), Tegner score increased significantly (4.7±1.5 vs 2.8±1.3, t=6.87, P<0.05), all improved significantly. AOFAS score was excellent in 19 cases, good in 4 cases and moderate in 1 case, the excellent and good rate was 95.8%. Among them, 20 cases (83.3%) were satisfied with the recovery effect after the operation. Postoperative sprain occurred in 5 cases (20.8%) and ankle mobility was limited in 3 cases (12.5%). Conclusions: The modified Karlsson operation (anchor method) can restore the stability of the ankle joint by treating the chronic rupture of CFL. It is an effective therapy for lateral ankle instability.
目的： 通过随访评价改良Karlsson手术（锚钉法）治疗陈旧性跟腓韧带断裂的治疗效果及其影响因素。 方法： 对2010年8月至2014年5月北京大学第三医院运动医学研究所手术治疗的24例跟腓韧带断裂的患者资料进行回顾性分析，所有病例均使用改良Karlsson手术（锚钉法）解剖修复跟腓韧带。其中男14例，女10例。平均年龄（30±9）岁。体质指数（BMI）平均（25±5）kg/m(2)。随访并分析术前和术后疼痛视觉模拟评分（VAS评分）、美国足踝外科协会评分（AOFAS评分）、Tegner膝关节运动评分、踝关节稳定性及活动度等。手术前后正态分布数据比较应用配对设计的t检验。 结果： 术后平均随访（41±13）个月。与术前相比，末次随访时VAS评分明显下降[0（0，7）比5（0，8），Z=4.13，P=0.000]，AOFAS评分明显提高[（94±10）分比（70±14）分，t=8.94，P<0.05]，Tegner评分明显提高[（4.7±1.5）分比（2.8±1.3）分，t=6.87，P<0.05]，均明显改善。AOFAS评分优19例，良4例，中1例，优良率95.8%；其中20例（83.3%）患者对术后恢复效果满意。术后再次扭伤5例（20.8%），踝关节活动度受限3例（12.5%）。 结论： 采用改良Karlsson手术（锚钉法）治疗陈旧性跟腓韧带断裂可恢复踝关节的稳定性，是慢性踝关节外侧不稳定的有效治疗方法。.
Keywords: Calcaneofibular ligament rupture; Chronic ankle instability; Modified Karlsson surgery.