Segond骨折的临床特点与治疗策略  

Surgical Treatment of Segond Fracture and Its Combined Injuries

作　　者：黄建明[1] 沈锋[1] 眭杰[1] 扶晓明[1] 康一凡[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海市200433

出　　处：《中国骨与关节损伤杂志》2011年第6期509-511,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨Segond骨折及其合并伤的关系以及外科处理方法的选择。方法回顾分析23例Segond骨折,其中19例合并前交叉韧带断裂在关节镜下采用LARS人工韧带重建前交叉韧带(其中同时重建内侧副韧带1例,外侧副韧带3例);3例合并前交叉韧带胫骨止点撕脱骨折中,2例以可吸收螺钉内固定,1例钢丝捆绑固定;1例单纯Segond骨折合并外侧不稳定,以Twinfix带线锚钉修补前外侧关节囊。术后采用IKDC和Lysholm膝关节功能评分评估患膝功能,通过KT-1000检查膝关节前后松弛度。结果所有患者均获得随访,19例采用LARS人工韧带重建前交叉韧带及3例前交叉韧带胫骨止点撕脱骨折患者,术前Lysholm膝关节功能评分及IKDC评分与术后评分差异均有统计学意义。1例单纯Segond骨折合并外侧不稳定,以Twinfix带线锚钉修补前外侧关节囊,取得了较好的临床效果。结论 Segond骨折强烈提示前交叉韧带损伤的存在,LARS人工韧带是目前治疗Segond骨折合并前交叉韧带损伤的较为理想的材料。对于单纯Segond骨折合并外侧不稳定时,选用Twinfix带线锚钉修补固定前外侧关节囊,是一种较为可行的外科处理方法。Objective To explore the relationship of Segond fracture and its combined injuries, and the choice of surgical treatment. Methods Twenty three cases of Segond fracture were studied retrospectively. Nineteen cases of Segond fracture combined with anterior cruciate ligament injuries were reconstructed under arthroscopy using LARS artificial ligament （including 1 case of MCL and 3 cases of LCL were reconstructed respectively）; 3 cases of Segond fracture combined avulsion fracture of the anterior crueiate ligament were treated under arthroscopy （2 cases were fixed with bio-absorbable screws, 1 case was treated with stainless sted wire）; 1 case of Segond fracture combined with lateral instability was repaired the anterolateral joint capsule using Twinftx suture anchor. IKDC and Lysholm knee score scale were used for functional evaluation. The anterior and posterior stability of the knee were examined with KT-1000. Results All pa- tients were followed up, according to Lysholm knee function score and IKDC score standards, the preoperative and postoperative results of 19 cases of Segond fracture combined with anterior cruciate ligament injuries and 3 cases of Segond fracture combined with avulsion fracture of the anterior cruciate ligament had statistical significance. Twinfix suture anchor was used to repair the anterolateral joint capsule in 1 case of Segond fracture and the clinical result was satisfied. Conclusion The evidence of Segond fracture strongly suggests the anterior cruciate ligament injuries. LARS artificial ligament is the ideal material currently for the treatment of Segond fracture combined with anterior cruciate ligament injury. When Segond fracture combined with anterolateral instability, using Twinfix suture anchor repair the antero- lateral joint capsule is a feasible solution for surgical treatment.

关 键 词：SEGOND骨折 前交叉韧带 关节镜 人工韧带 LARS 手术治疗 

分 类 号：R683.42[医药卫生—骨科学]