| 膝关节多韧带损伤的手术治疗体会 |
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Received:September 13, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 许桦 |
XU Hua |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
xuhua365@163.com |
| 陈亿民 |
CHEN Yi-min |
萧山区第一人民医院骨科, 浙江 杭州 311201 |
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| 翟利锋 |
ZHAI Li-feng |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 毕大卫 |
BI Da-wei |
萧山区第一人民医院骨科, 浙江 杭州 311201 |
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| 期刊信息：《中国骨伤》2016年29卷，第5期，第456-459页 |
| DOI：10.3969/j.issn.1003-0034.2016.05.013 |
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| 目的:介绍膝关节多韧带损伤的手术治疗方法和结果,总结治疗的经验与教训。方法:随访自2008年至2013年经治的26例膝关节多韧带损伤患者,其中男17例,女9例;年龄29～55岁,平均40.7岁。所有患者在关节镜下采用自体或异体肌腱重建交叉韧带,并同时修补内侧副韧带、外侧副韧带及处理内外侧复合体损伤。9例分期手术,其余均采取Ⅰ期手术处理所有损伤。用Lysholm膝关节评分评价手术前后膝关节功能。结果:26例均获随访,时间为0.8～3.2年,平均1.6年,手术平均等待时间为1.2个月。术前膝关节Lysholm评分42.5±4.5(33～48分),终末随访时78.1±3.9(57～95分),随访时评分提高。术后关节活动度均超过90°,内外翻试验正常或接近正常,所有患者在屈70°时Lachman试验阴性。结论:膝关节韧带多发损伤应首选关节镜下Ⅰ期重建;如无法Ⅰ期同时重建前后交叉韧带,则Ⅰ期先重建后交叉韧带,Ⅱ期重建前交叉韧带;后交叉韧带因多种原因易漏诊,避免因术前准备不充分而分期手术。 |
| [关键词]:膝关节 前交叉韧带 后交叉韧带 关节镜 |
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| Surgical treatment of multiple ligament injuries of knee joints |
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| Abstract:Objective: To study operative effects for the treatment of multiple ligament injuries of knee joints. Methods: From 2008 to 2013,26 patients(17 males and 9 females) with multiple ligament injuries of knee joints were treated surgically. The average age was 40.7 years old,ranging from 29 to 55 years old. All the patients were treated with arthroscopic reconstruction of cruiate ligament with autogenous or allogeneic hamstrings and tendon,and at the same time received repair of medial collateral ligament and lateral collateral ligament,as well as the treatment of exterior and interior complex injuries. Nine patients received second stage operation after the initial operation for mistake or missed diagnosis,and other patients were treated at the first stage. The Lysholm scoring system was used to evaluate function and stability of knee joints before and after operation. Results: All the patients were followed up for an average duration of 1.6 years(ranged,0.8 to 3.2 years). The mean awaiting time for operation was 1.2 months. The Lysholm score was improved from preoperative 42.5±4.5(ranged,33 to 48) to the latest follow-up 78.1±3.9(ranged,57 to 95). The function of knee joint was improved obviously in the arthroscopic reconstruction patients,with joint range of motion exceeding 90° and with Varus & Valgus tests near to normal. All the patients had negative findings in the Lachman test at 70° of flexion. Conclusion: Arthroscopic reconstruction should be the first choice in treating multiple ligament injuries of knee joints. If the anterior and posterior cruciate ligament injuries can't be treated simultaneously,the posterior cruciate ligament injuries should be treated preferentially at the first stage and the anterior cruciate ligament injuries should be treated at the second stage. The diagnosis of posterior cruciate ligament is easy to be missed. |
| KEYWORDS:Knee joint Anterior cruciate ligament Posterior cruciate ligament Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 许桦,陈亿民,翟利锋,毕大卫.膝关节多韧带损伤的手术治疗体会[J].中国骨伤,2016,29(5):456~459 |
| 英文格式: | XU Hua,CHEN Yi-min,ZHAI Li-feng,BI Da-wei.Surgical treatment of multiple ligament injuries of knee joints[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(5):456~459 |
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