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Reconstrucción del ligamento fibulotalar anterior: resultados de una tècnica mínimamente invasiva

医学 距腓前韧带 韧带 脚踝 外科 支持带 关节囊 三角肌韧带 肌腱
作者
Álvaro Santiago Guerrero Forero,Léon E. de La Hoz,Alejandra Fonseca Carrascal,J. Osuna Jiménez
摘要

Objective: The inversion ankle trauma is one of the most frequent reasons for consultation in the ED patients both athletes and non-athletes. As a result of trauma it is up to 85% of cases, sprains capsule-ligament complex lateral ankle, being more common commitment talofibular ligament above. Up to 20% of cases chronic mechanical instability and functional limitation occurs, manifesting with pain, recurrent sprains; reaching to generate long-term alterations in the biomechanics of ankle osteoarthritis and osteochondral lesions. In this type of trauma and to the persistence of symptoms, it is indicated early surgery with the aim of stabilizing the tibiotalar joint and avoid possible consequences. Methods: It is a cross-sectional study, which aims is to identify the mechanical and functional results of anatomic ligament reconstruction fibulotalar and augmentation with inferior extensor retinaculum by a minimally invasive approach in 57 patients operated on in a clinic Bogota Colombia, between January 2014 and December 2015. Results: Fifty-seven ankles were followed in 57 patients over a period of time between 15 months and 3 months. The common diagnosis in all patients was functional and mechanical instability, in all cases underwent anatomic ligament reconstruction fibulotalar with autograft anterior inferior extensor retinaculum, for a minimally invasive approach. All patients were evaluated in the preoperative AOFAS functional scale with an average of 52 (31-54) and qualified in the postoperative period with the same scale yielding an average result of 97 (90-100). Complications granuloma, tarsal sinus syndrome in four patients and a neuropraxia of cutaneous branch of the superficial peroneal nerve is presented. Conclusions: This is a reliable and reproducible technique functional and mechanically comparable to conventional techniques described, but with the advantages of a minimally invasive technique: less post-operative edema, easy pain management, rehabilitation and early return to previous activities injury.

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