双套索锁扣结错位缝合悬吊固定法修复膝关节内侧副韧带起点断裂  

REPAIR OF ORIGIN OF MEDIAL COLLATERAL LIGAMENT RUPTURE WITH MALPOSED-SUTURE HANGING AND FASTENING METHOD OF DOUBLE-LARIAT LOCK CATCH KNOT

作　　者：冯晓娜[1,2] 李春江[1,3] 李文宏[1,3] 徐开达[1,4] 

机构地区：[1]唐山市第二医院 [2]华北煤炭医学院附属骨科医院门诊科,河北唐山063000 [3]华北煤炭医学院附属骨科医院急诊科,河北唐山063000 [4]华北煤炭医学院附属骨科医院关节科,河北唐山063000

出　　处：《中国修复重建外科杂志》2010年第6期701-703,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨双套索锁扣结错位缝合悬吊固定法修复膝关节内侧副韧带(medial collateral ligament,MCL)起点断裂的方法及疗效。方法 2008年2月-2009年2月,采用双套索锁扣结错位缝合悬吊固定法修复36例急性单纯MCL股骨内上髁附着点断裂。男21例,女15例;年龄17～58岁,平均40岁。左膝19例,右膝17例。车祸伤5例,摔伤11例,踢伤3例,挤压伤4例,扭伤13例。双膝关节应力位X线片示患膝关节内侧关节间隙较健侧增加6.5～13.5mm,平均11.2mm。受伤至手术时间为36h～8d,平均3.5d。结果术后切口均Ⅰ期愈合。31例获随访,随访时间12～20个月,平均15个月。随访期内无感染、下肢深静脉血栓、韧带再次断裂等并发症发生。术后12个月患膝关节内侧关节间隙较健侧增加1.5～5.6mm,平均3.5mm。术后疗效根据Lysholm标准评定:优20例,良11例,优良率为100%。结论双套索锁扣结错位缝合悬吊固定法修复MCL起点断裂具有损伤小,把持韧带纤维牢固,经骨隧道固定可靠,可早期恢复膝关节稳定性,并获得良好的功能恢复等优点。Objective To investigate the method and curative effect of malposed-suture hanging and fastening method of double-lariat lock catch knot in repairing origin of medial collateral ligament（MCL） rupture.Methods From February 2008 to February 2009,36 patients with acute MCL rupture were treated with malposed-suture hanging and fastening method of double-lariat lock catch knot.There were 21 males and 15 females with an average age of 40 years（range,17-58 years）,including 19 left knees and 17 right knees.Repture was caused by traffic accident in 5 cases,by falling in 11 cases,by kicking in 3 cases,by crush in 4 cases,and by sprain in 13 cases.The X-ray films of double knees at stress state showed the medial joint space of affected knee joint increased 6.5-13.5 mm（11.2 mm on average） when compared with that of normal knee joint.The time from injury to operation was 36 hours to 8 days（3.5 days on average）.Results All wounds healed by first intention.Thirty-one cases were followed up 12-20 months（15 months on average）.No complication of wound infection,deep venous thrombosis,and ligament rerupture occurred.The medial joint space of affected knee joint increased 1.5-5.6 mm（3.5 mm on average） when compared with that of normal knee joint.According to Lysholm assessment standard,the results were excellent in 20 cases and good in 11 cases,the excellent and good rate was 100%.Conclusion Repair of origin of MCL with malposedsuture hanging and fastening method of double-lariat lock catch knot has advantages of less injury,reliable fixation,and rapid recovery of knee stability.

关 键 词：膝关节 内侧副韧带 韧带断裂 套索锁扣结 修复 

分 类 号：R687.3[医药卫生—骨科学]