膝关节后内侧结构损伤合并交叉韧带断裂的手术治疗
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery(2013)
Abstract
目的探讨手术治疗膝关节后内侧结构(posteromedial corner,PMC)损伤合并前交叉韧带(anteriorcruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)断裂的方法及疗效。方法 2009年2月-2012年2月,收治15例15膝PMC损伤合并ACL、PCL断裂患者,采用缝合锚钉修复PMC联合一期或二期重建ACL、PCL治疗。男7例,女8例;年龄15~59岁,平均39岁。致伤原因:交通事故伤6例,运动伤7例,扭伤2例。受伤至手术时间3~15 d,平均7 d。外翻应力试验及前、后抽屉试验均呈阳性,关节功能障碍。ACL和PCL断裂3例,ACL断裂5例,ACL胫骨髁间嵴撕脱3例,PCL断裂4例。PMC于股骨止点撕裂9例,胫骨止点撕裂5例,体部撕裂1例。结果术后切口均Ⅰ期愈合,无并发症发生。15例均获随访,随访时间10~36个月,平均18.4个月。末次随访时14例膝关节屈、伸范围正常,1例伸直受限10°。外翻应力试验除1例呈弱阳性外,其余患者均为阴性;前、后抽屉试验均为阴性。采用改良Lysholm评分标准评定疗效:获优8例,良5例,可2例,优良率86.7%。结论膝关节PMC损伤合并ACL、PCL断裂时,早期修复PMC并合理修复重建交叉韧带能有效恢复膝关节稳定性。
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Key words
posteromedial corner of knee cruciate ligament arthroscopy suture anchor
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