• 제목/요약/키워드: 외측 불안정증

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반건양근 건을 이용한 족관절 외측 인대의 해부학적 재건 (Anatomical Reconstruction of the Lateral Ankle Ligaments using Semitendinosus)

  • 이우천
    • 대한정형외과스포츠의학회지
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    • 제7권1호
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    • pp.19-23
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    • 2008
  • 족관절 만성 외측 불안정증을 비해부학적인 방법으로 재건한 후에 발생하는 여러가지 문제점들을 해결하기 위하여 해부학적으로 재건하는 여러가지 방법이 보고되었다. 해부학적인 위치로 재건하는 것이 정상 관절 역학과 안정성을 회복하는데 중요하다. 해부학적인 재건 방법의 가장 큰 문제점은 인대를 정상적인 주행 방향으로 재건하는 것이 매우 어렵다는 점인데, 저자는 전거비 인대와 종비 인대가 서로 인접하여 위치하므로 두 인대의 비골측 부착부에 한 개의 터널을 만드는 것이 각각의 인대가 통과 할 별도의 터널을 만드는 것보다 좀 더 해부학적이라고 생각하였다. 이 논문에서는 외측 인대의 해부학적 재건에 필요한 기초 지식을 알아보고 반건양건을 이용한 재건 수술 방법을 소개하였다.

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만성 족관절 외측 불안정증 (Chronic Lateral Ankle Instability)

  • 정홍근;박재용;박종태
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.73-78
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    • 2012
  • Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

족관절 만성 외측 불안정증에서 관절경하 변형 Brostr$\ddot{o}$m 술식의 수술적 결과 (Surgical Outcomes of Arthroscopic Modified Brostr$\ddot{o}$m Procedure in Chronic Lateral Ankle Instability)

  • 차민석;차승도;김응수
    • 대한족부족관절학회지
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    • 제17권4호
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    • pp.283-287
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    • 2013
  • Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

Broström 술식과 비골 골막 젖힘 보강술로 치료한 구상 발목관절에 동반된 족근관절 외측 불안정증: 증례 보고 (Broström Procedure and Fibula Periosteal Turn Down Augmentation for the Ball-and-Socket Ankle Accompanying Lateral Ankle Instability: A Case Report)

  • 신우진;조홍만;박지연
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.98-101
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    • 2020
  • We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

Modified Brostrom 술식을 이용한 만성 족근관절 외측 불안정증의 치료 (Treatment for Chronic Lateral Instability of the Ankle with Modified Brostrom Procedure(6 cases))

  • 박용욱;정용기;유정한;이강일
    • 대한족부족관절학회지
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    • 제2권1호
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    • pp.6-12
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    • 1998
  • Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

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만성 외측 발목 불안정증의 수술적 치료 (Surgical Procedures for Chronic Lateral Ankle Instability)

  • 양기원;이홍섭;황지선
    • 대한족부족관절학회지
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    • 제25권1호
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    • pp.17-24
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    • 2021
  • Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, non-anatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited. The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증 (The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability)

  • 박재용;최기원;조재호;강찬;최경진;정진화;김학준;배서영;차승도;김기천;한승환;2015 대한족부족관절학회 보험장애판정위원회
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.12-18
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    • 2016
  • Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.