关节镜下应用钮扣式钢板固定四股自体股腘绳肌腱重建前交叉韧带  

Arthroscopic Reconstruction of Anterior Cruciate Ligament with Hamstring Tendons and Button-Suture Plate

作　　者：肖祥池[1] 周英祝[1] 杨文斌[1] 杨仁轩[1] 卢颂华[1] 陈伯健[1] 王昭佩[1] 

机构地区：[1]广东省中医院骨科,广州510105

出　　处：《中国微创外科杂志》2007年第8期801-802,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨关节镜下应用钮扣式钢板固定四股自体腘绳肌腱重建膝关节前交叉韧带（anterior cruciate ligament,ACL）的临床疗效. 方法 对32例前交叉韧带损伤者在关节镜下应用钮扣式钢板固定四股腘绳肌腱重建术.术前和术后进行Lachman试验、轴移试验评估膝关节的稳定性,用Lysholm评分法评价膝关节功能.术前常规行MRI及膝关节正侧位、髌骨轴位X线片检查,排除前交叉韧带起止点骨性撕脱. 结果 32例随访3.5～29个月,其中25例＞12个月.所有病例膝关节不稳定感明显改善.术前Lachman试验阳性32例,轴移试验阳性28例.Lysholm综合评分51.8±5.6.术后Lachman试验30例阴性,2例弱阳性,轴移试验均为阴性,膝关节功能Lysholm综合评分为90.7±2.5.3例关节积液,经关节穿刺抽吸后吸收. 结论 关节镜下应用钮扣式钢板固定四股自体腘绳肌腱重建膝ACL的近期临床疗效良好.Objective To study the efficacy of arthroscopic reconstruction of anterior cruciate ligament （ACL） with hamstring tendons and button-suture plate. Methods Thirty-two cases of ACL rupture received arthroscopic reconstruction with hamstring tendons and button-suture plate. The Lachman test and Pivot shift test were performed before and after operation to assess the stability of the knee joint. The knee function was evaluated according to Lysholm rating scale. Regular MRI, anterioposterior and lateral films of knee joint, patella axial radiography were conducted before the operation, to exclude the possibility of osteal avulsion at both ends of ACL. Results The 32 cases were followed for 3.5 - 29 months, in which 25 cases were more than 12 months. The knee stabilities of all cases recovered. The preoperative Lachman test results were positive in 32 cases, and the Pivot shift test results were positive in 28 cases. Lysholm rating score was 51.8 ± 5.6. The postoperative Lachman tests result were negative in 30 cases, and weakly positive in 2 cases. The Pivot test showed negative results in all the cases. The Lysholm rating score was increased to 90.7 ± 2.5 after the operation. Three cases experienced joint effusion and were treated with puncture aspiration. Conclusions The short-term clinical effect of arthroscopic reconstruction of ACL with hamstring tendons and suture plate is favorable.

关 键 词：前交叉韧带 四股腘绳肌腱 钮扣式钢板 关节镜 重建 

分 类 号：R687.3[医药卫生—骨科学]