自体中1／3股二头肌腱和股薄肌重建膝关节后外侧角韧带复合体损伤  

Reconstruction of posterolateral complex injury of the knee with autogenous middle 1/3 of biceps femoris tendon and gracilis

作　　者：陈鸿[1] 鲁宁[1] 张颖[1] 刘宗良[2] 刘路平[1] 马梦昆[1] 

机构地区：[1]昆明医学院第二附属医院骨科,650101 [2]昆明医学院解剖教研室

出　　处：《中华创伤杂志》2008年第4期256-259,共4页Chinese Journal of Trauma

基　　金：云南省教育厅基金资助项目（5Y0289C）

摘　　要：目的探讨采用自体中1／3股二头肌腱和股薄肌重建膝关节后外侧角韧带复合体（PLC）的技术及近期的疗效。方法本组21例，均为联合型的直向外侧＋后外侧旋转〉Ⅱ度不稳定，重建范围：胭肌腱、外侧副韧带、胭腓韧带。术中单独提取健侧或患侧股薄肌重建胭肌腱。切取股二头肌肌腱中1／3部，折叠后对折端拉入股骨外髁骨隧道固定，分出的前束重建外侧副韧带（LCL），后束重建胭腓韧带。结果术后随访6—24个月，平均16个月。Lysholm膝关节功能评分，术前为（43±2）分，术后半年为（90±3）分，有明显改进。结论PLC损伤可造成患肢功能受损，采用自体中1／3股二头肌腱和股薄肌修复重建韧带手术可获得良好预后。Objective To introduce the method of reconstructing posterolateral complex injury of the knee with the autogenous middle 1/3 of biceps femoris tendon and gracilis and evaluate its short-term outcome. Methods There were 21 cases of posterolateral complex injury of the knee reconstructed with the middle 1/3 of biceps femoris tendon and gracilis from January 2003 to December 2006. There were 13 males and 1 female at age range of 18-49 years （ mean 34.3 years）. The reconstructed ligaments included popliteal tendon, lateral collateral ligament and poplitrofibular ligament. An autogenous folded gracilis tendon was extracted and placed through trastibial bony tunnel from anterolateral to the posterior condylar of the tibia to reconstruct the popliteal tendon. An autogenous folded middle 1/3 of biceps femoris tendon was fixed in the isometric bony tunnel of the femoral lateral condyle. The anterior half was used to reconstruct the lateral collateral ligament, and the posterior half to reconstruct the poplitrofibular ligament. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results All cases were followed up for average 26 months （6-24 months）. Lysholm score of the knee was （43 ± 2） points preoperatively and （ 90 ± 3 ） points half year after operation, with significant improvement. Conclusions PCL injury may result in functional deficiency of the injured extremity. While the autogenous middle 1/3 of biceps femoris tendon and gracilis can yield a stable knee with good function, mini-trauma and satisfactory clinical results in reconstructing the posterolateral complex of the knee joint.

关 键 词：膝损伤 膝关节 后外侧角韧带复合体 

分 类 号：R687[医药卫生—骨科学]