什么是外侧踝关节韧带重建?

Lateral ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. 这也被称为布罗斯特罗姆手术. It’s most often done as an outpatient surgery, so you can go home the same day.

Your ankle is a hinge joint that allows motion up and down, and from side to side. 你的脚和脚踝有几根韧带. These are strong band-like structures that keep the bones in your ankle and feet tightly connected. 在脚的外侧，有几条韧带. These include the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). 这些可以帮助你走路时保持脚踝和脚的稳定.

If you have had 反复扭伤脚踝 or if you have certain foot deformities, 你的韧带会开始变得脆弱和松弛. 如果发生这种情况，你的脚踝可能会变得不稳定.

在踝关节外侧韧带重建期间, 外科医生在你的脚踝外侧开了一个小口子. 这是在全身麻醉的情况下进行的. Then your surgeon tightens one or more of the ligaments on the outside of your foot.

为什么我可能需要踝关节外侧韧带重建?

You might need this surgery if one or more of the ligaments on the outside of your ankle has loosened or stretched. 这会导致慢性踝关节不稳定. 它会引起慢性疼痛, 反复扭伤脚踝, and an ankle that often gives way when you walk or perform activities.

At first, an ankle sprain may stretch and partially tear your ankle ligaments. This first sprain makes it more likely that you will sprain your ankle again. This is more likely if you did not have the first sprain treated properly. 更多的扭伤会使韧带更加松弛.

Certain mechanical problems with your foot can make you more likely to develop an unstable ankle, 如:

• Hindfoot弓形腿
• 足底屈曲的第一道光线
• 足中凹窝(高足弓)
• General looseness of your ligaments—for example, from a medical condition like Ehlers-Danlos

You may have already been treated with physical therapy and special foot inserts. A healthcare provider may advise surgery if other treatments for your ankle haven’t worked. It’s not common to need this surgery right after a first ankle sprain.

What are the risks of a lateral ankle ligament reconstruction?

每个手术都有风险. 该手术的风险包括:

• 过量出血
• 神经损伤
• 感染
• 踝关节僵硬
• 血凝块
• 麻醉并发症
• 你的脚踝稳定性没有改善

你患并发症的风险取决于你的年龄, 你脚的解剖结构, 你的总体健康状况. Talk with your healthcare provider about any concerns you might have. 你可以讨论最适合你的风险.

How do I get ready for a lateral ankle ligament reconstruction?

Talk with your healthcare provider about how to prepare for your surgery. Ask if you should stop taking any medicines ahead of time, like blood thinners. 如果你吸烟，试着在手术前戒烟. Tell your healthcare provider about all the medicines you take. 这包括阿司匹林等非处方药. Also, tell him or her about any changes in your overall health, like a recent fever.

Before your procedure, you may need imaging tests, such as X-rays or an MRI. You should not eat or drink anything after midnight the night before your procedure.

You may need to plan some changes to your home and activities before surgery. 你有一段时间不能正常走路了.

在踝关节外侧韧带重建过程中会发生什么?

There are a number of methods used for lateral ankle ligament reconstruction. Ask your healthcare provider about the details of your surgery. 骨科足外科医生将为你做手术. 手术可能需要2个小时或更长时间. 您可以期待以下内容:

• You will probably receive general anesthesia to make you sleep through the procedure or regional anesthesia to numb the involved leg.
• 在手术过程中, 你的生命体征, 比如你的心率和血压, 会被仔细观察.
• 清洁患处后, your surgeon will make a cut through the skin and muscle of your ankle.
• If your surgery is minimally invasive, your surgeon will cut a small incision. He or she will put small instruments and a camera through the incision to perform your surgery.
• Your surgeon may remove your ATFL and your CFL ankle ligaments from where they attach on your fibula.
• 他或她可能使这些韧带变短.
• Your surgeon may then reattach these ligaments to your fibula by using small new holes drilled into your bone.
• 如果有必要，你的外科医生可能会做其他修复.
• The layers of skin and muscle around your ankle will be surgically closed.

踝关节外侧韧带重建后会发生什么?

手术后会有人照看你几个小时. When you wake up, you will likely find your ankle in a splint. Often, lateral ankle ligament reconstruction is an outpatient procedure. 这意味着你可以在同一天回家. 你应该找人开车送你回家.

You will have some pain for a while after your surgery, especially for the first few days. 止痛药可能有助于减轻你的疼痛. Carefully follow all instructions about medicines and wound care. Keeping your leg elevated may help reduce swelling and pain, too. You’ll probably need to use crutches and keep weight off your ankle for at least a few weeks. Make sure to tell your surgeon right away if you have high fever, 发冷, 或者脚踝越来越疼.

You will need to return in about 10 days after your surgery to have your stitches or staples removed. Your surgeon might also replace your splint with a boot or cast at this time. In a few weeks, your healthcare provider will likely replace this cast with a removable brace. 你需要使用这个支架几个月.

Your healthcare provider will give you specific instructions about how to strengthen your ankle and leg muscles as you recover. 你也可以从物理治疗中受益. This will help make sure that your surgery will be a success.

下一个步骤

Before you agree to the test or the procedure make sure you know:

• 测试或程序的名称
• 你进行测试或程序的原因
• 期待什么样的结果?它们意味着什么
• 测试或程序的风险和益处
• 可能的副作用或并发症是什么
• 你在何时何地进行测试或程序
• Who will do the test or procedure and what that person’s qualifications are
• 如果你不做检查或不做手术会怎么样
• 有没有其他的测试或程序可以考虑
• 你何时以及如何得到结果
• Who to call after the test or procedure if you have questions or problems
• 你需要支付多少检查费用