| 12例急性膝关节后外侧结构损伤的手术治疗 |
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Received:September 08, 2011
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| 期刊信息：《中国骨伤》2012年25卷，第5期，第400-403页 |
| DOI：10.3969/j.issn.1003-0034.2012.05.012 |
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目的：探讨急性膝关节后外侧结构(posterolateral structures,PLS)损伤的手术方法及疗效。
方法：2006年5月至2008年10月收治急性PLS损伤患者12例(12膝),男9例,女3例;年龄23～47岁,平均31岁。其中合并后交叉韧带损伤9例,前后交叉韧带损伤3例,关节囊撕裂7例。首先在关节镜下探查,修复损伤半月板,前后交叉韧带损伤者与PLS同期重建,根据PLS损伤程度采用异体肌腱解剖重建腘肌腱单位(popliteus muscle tendon unit,PMTU)和(或)外侧副韧带(lateral collateral ligament,LCL),PLS重建完成后进行交叉韧带的重建固定,合并关节囊撕裂的采用局部加强缝合的手术方法治疗,术后根据IKDC及Lysholm功能评定标准评定膝关节功能恢复情况。
结果：12例均获随访,时间12～24个月,平均(16.5±3.2)个月。根据IKDC综合评定标准,正常(A级)8膝,接近正常(B 级)3膝,异常(C级)1膝。Lysholm膝关节功能评分从术前的(39.6±3.1)分增加到术后的(85.1±2.2)分,患膝红、肿、疼痛均消失。
结论：急性PLS损伤需手术解剖重建PMTU、LCL等结构,手术操作的要求精度较高,不仅需要精确地建立骨隧道,还要注意保护腓总神经和避免植入的异体肌腱切割,使重建的膝关节后外侧结构更加稳定。 |
| [关键词]:膝关节 韧带 创伤和损伤 修复外科手术 |
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| Surgical treatment for acute posterolateral structures injuries of the knee joint in 12 patients |
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Abstract:
Objective:To investigate the clinical results of surgical treatment for acute posterolateral structures(PLS) injuries of knee joint.
Methods:Twelve patients(12 knees) with acute PLS injuries were treated from May 2006 to October 2008,including 9 males and 3 females,ranging in age from 23 to 47 years,with an average of 31 years. Nine patients had posterior cruciate ligament (PCL) injuries,3 patients had both anterior cruciate ligament (ACL) and PCL injuries,and 7 patients had articular capsule injuries. The knee joint was explored under arthroscope and the meniscuses were repaired firstly,then the ACL was rebuilt,as well as the PCL and PLS at the same time. The popliteus muscle tendon unit(PMTU) and the lateral collateral ligament(LCL) were anatomy reconstructed using variant tendon according to the degree of injury. The cruciate ligament reconstructed and fixed after the PLS reconstruction. The capsule tears were treated by reinforced suture techniques in the end. IKDC and Lysholm score were used to evaluate the postoperative knee joint function.
Results:All the patients were followed up,and the duration ranged from 12 to 24 months,with an average of (16.5±3.2) months. According to IKDC standard,8 cases restored to normal(grade A),3 cases near to normal(grade B) and 1 poor(grade C). The preoperative Lysholm joint function score was (39.6±3.1) and improved to (85.1±2.2) after surgery. All the patients were satisfied with their operation because of no-swelling and no-pain of the knee joint.
Conclusion:The acute PLS injuries should be repaired with anatomy reconstruction of the PMTU and LCL which were the most important structure of the PLS. The operative procedure required accurate establishment of the bone tunnel,protection of fibular nerve,and avoiding the incision of the variant tendon,thus can make the PLS more stable after the reconstruction. |
| KEYWORDS:Knee joint Ligament Wounds and injuries Reconstructive surgical procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王绍宏.12例急性膝关节后外侧结构损伤的手术治疗[J].中国骨伤,2012,25(5):400~403 |
| 英文格式: | WANG Shao-hong.Surgical treatment for acute posterolateral structures injuries of the knee joint in 12 patients[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(5):400~403 |
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