| Segond骨折及合并损伤的临床诊治分析 |
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Received:July 19, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 孙斌 |
SUN Bin |
舟山市中医骨伤联合医院骨科, 浙江 舟山 316000 |
Department of Orthopaedics, Orthopaedic and TCM Hospital of Zhoushan, Zhoushan 316000, Zhejiang, China |
sunbin7812@sina.com |
| 吴旭东 |
WU Xu-dong |
舟山市中医骨伤联合医院骨科, 浙江 舟山 316000 |
Department of Orthopaedics, Orthopaedic and TCM Hospital of Zhoushan, Zhoushan 316000, Zhejiang, China |
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| 沈万祥 |
SHEN Wan-xiang |
舟山市中医骨伤联合医院骨科, 浙江 舟山 316000 |
Department of Orthopaedics, Orthopaedic and TCM Hospital of Zhoushan, Zhoushan 316000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第2期，第149-153页 |
| DOI：10.3969/j.issn.1003-0034.2016.02.013 |
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目的:研究Segond骨折的手术时间与方法和临床表现特点.
方法:2010年6月至2014年12月期间,收治10例Segond骨折病例,均为男性,年龄26~69岁,平均42岁.其中,伤后7~10 d行关节镜探查发现前交叉韧带完全断裂及半月板损伤6例;伤后7~10 d行关节镜探查发现前交叉韧带胫骨侧止点撕脱骨折并半月板损伤2例;伤后4~8周行关节镜探查手术2例,发现前交叉韧带及后交叉韧带同时完全断裂并半月板损伤1例,前交叉韧带完全断裂无后交叉韧带断裂1例.针对交叉韧带完全断裂的患者在关节镜探查后行交叉韧带重建术,9例半月板损伤患者给予半月板成形术或缝合术,2例前交叉韧带胫骨止点撕脱骨折的病例则在关节镜下采用爱惜邦捆绑固定技术进行复位与固定.术后采用Lysholm膝关节评分标准进行疗效评价.
结果:伤后10 d手术干预的8例,膝关节在术后3 d时肿胀明显,给予关节腔穿刺发现淡血性液,术后1周开始护具保护并下床.伤后4~8周行手术处理的2例,膝关节在术后3 d时无明显肿胀,进行关节腔穿刺抽吸未发现淡血性液,术后3 d能在护具保护下活动及下床.术后10例均获随访,时间12~24个月,平均18个月.Lysholm膝关节评分术后高于术前,治疗结果满意.
结论:关于Segond骨折,正确且早期诊断对治疗至关重要;Segond骨折往往伴发前交叉韧带损伤和半月板损伤,关节镜下手术(包括交叉韧带重建和半月板修复等)的最佳手术时间宜在伤后4周~2个月内进行,且需要依据不同并发症挑选个性化的治疗方案. |
| [关键词]:Segond骨折 前交叉韧带 创伤和损伤 |
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| Analysis on treatment and diagnosis of Segond fracture combined with injuries |
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Abstract:
Objective:To investigate the clinical characteristics of Segond fracture combined with injuries,and to explore the operative method and opportunity.
Methods:From June 2010 to December 2014,10 patients with Segond fracture were treated. There were 10 males,ranging in age from 26 to 69 years old,with a mean of 42 years old. Under arthroscopy examination within 7 to 10 days after injury,6 patients had compete rupture of anterior cruciate ligament and meniscus injury;2 patients had tibial avulsion fractures of the ACL combined with meniscus injury. At 4 to 8 weeks after injury,2 patients were performed with arthroscopy examination;1 patient had complete rupture of anterior and posterior cruciate ligament combined with meniscus injury;and the other patient had complete rupture of anterior cruciate ligament alone. All the patients with cruciate ligament rupture were treated with reconstruction of cruciate ligament; 9 patients had meniscus injuries were treated with menisus plasty or suture;and 2 patients had tibial avulsion fractures of the ACL were treated with non-absorbable Ethicon suture fixation under arthroscopy. After operation,the Lysholm scoring system was used to evaluate clinical effects.
Results:Eight patients were operated within 10 days after injury,the knee joints swelling was obvious at the 3rd day after operation,and blood oozing was found by joint puncture. These 8 patients did out-of-bed activity with assistance at 1 week postoperatively. Other 2 patients performed operation in 4 to 8 weeks after injury without knee joint obvious swelling at the 3rd day after operation,and no blood oozing was found by joint puncture. These 2 patients did out-of-bed activity with assistance after 3 days postoperatively. All the patients were followed up,and the duration ranged from 12 to 24 months,with an average of 18 months. Postoperative Lysholm score of all patients was higher than preoperative scor,and the results were satisfactory.
Conclusion:For Segond fractures,firstly,it is important to gain early diagnosis for treatment. Secondly,it is often associated with the rupture of anterior cruciate ligament and meniscus injuries,and the best time of cruciate ligament rebuilding and meniscus repairing maybe between 4 to 8 weeks after injury. Thirdly,personalized treatment should be chosen according to different complications. |
| KEYWORDS:Segond fracture Anterior cruciate ligament Wounds and injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙斌,吴旭东,沈万祥.Segond骨折及合并损伤的临床诊治分析[J].中国骨伤,2016,29(2):149~153 |
| 英文格式: | SUN Bin,WU Xu-dong,SHEN Wan-xiang.Analysis on treatment and diagnosis of Segond fracture combined with injuries[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(2):149~153 |
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