解剖重建前交叉韧带前内侧束或后外侧束的临床观察  

Clinical effect of anteriomedial blund or posteriolateral blund anatomical reconstruction of anterior cruciate ligament

作　　者：程亮亮[1] 林涛[1] 姜虹[1] 高春林[1] 代均[1] 袁博[1] 

机构地区：[1]大连市友谊医院骨外二科,辽宁大连116001

出　　处：《临床骨科杂志》2011年第2期195-197,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨关节镜下应用可吸收Rigidfix交叉钉与Intrafix膨胀挤压螺钉固定自体或异体肌腱解剖重建膝关节前交叉韧带（ACL）的前内侧束或后外侧束的疗效。方法对18例ACL单束损伤患者,在关节镜下保留未损伤的部分ACL、建立骨隧道、穿过移植肌腱、股骨侧用可吸收Rigidfix交叉钉固定,胫骨侧用Intrafix膨胀挤压螺钉固定。结果 18例均获随访,时间6-27个月。术后患者疼痛均消失,关节稳定,恢复关节活动度,固定物无松动。1例出现关节积液和滑膜炎,经保守治疗后好转。IKDC分级：术前B级5例、C级10例、D级3例,术后A级8例、B级8例、C级2例,差异有统计学意义（P〈0.01）。Lysholm评分：术前（68.34±4.53）分,术后（93.24±3.61）分,差异有统计学意义（P〈0.01）。结论关节镜下应用Rigidfix交叉钉与In-trafix膨胀挤压螺钉固定自体或异体肌腱重建膝关节ACL的前内侧束或后外侧束,方法简便、固定确实,恢复其解剖结构,保留的部分束促进韧带愈合,利于膝关节本体觉建立和早期功能康复。Objective To explore the surgical technique and clinical effects of arthroscopic anteriomedial blund or posterolateral blund reconstruction of anterior cruciate ligament（ACL） with autogenetic or allogenic tendons using absorbable Rigidfix cross pins and Intrafix screw.Methods There were 18 cases,who underwent the anteromedial or posterolateral bundle of ACL reconstruction by this method.Retaining the residual partial ACL,the tunnel was made and inserted the tendons.The tendons were fixed onto the femoral side by Rigidfix pins,while onto the tibial side by Intrafix screw.Results All of 18 patients had been followed up for 6~27 months.There was no pain,no limitation of range of motion and no loosening of the pins and screws.Only 1 case suffered from effusion and synovitis after surgery and recovered after management.The preoperative IKDC evaluation was as follows： B,5 cases;C,10 cases;D,3 cases;and postoperative,A,8 cases;B,8 cases;C,2 cases（P0.01）.Lysholm scores increased from 68.34±4.53 to 93.24±3.61（P0.01）.Conclusions Using Rigidfix-Intrafix complexes for anteriomedial blund or posterolateral blund of ACL reconstruction is simple,which provides rigid fixation and restores the anatomy structure.The remained partial ACL promots the tendons healing,and is beneficial for setting up proprioceptive sensation of knee and a early rehabilitation after operation.

关 键 词：关节镜检查 前交叉韧带/外科学 前内侧束 后外侧束 

分 类 号：R686.5[医药卫生—骨科学] R687.4[医药卫生—外科学]