应用无内固定装置技术双束双隧道重建前交叉韧带疗效分析  

Reconstruction of Anterior Cruciate Ligament by Internal Fixation-free Technique plus Double-Bundle and Double-Dunnel

作　　者：冯会成[1] 黄迅悟[1] 孙继桐[1] 常青[1] 

机构地区：[1]中国人民解放军第309医院骨科,北京100091

出　　处：《现代生物医学进展》2011年第14期2727-2729,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金(30901532)

摘　　要：目的：探讨应用无内固定装置技术双束双隧道重建前交叉韧带（ACL）的治疗效果。方法：2006年1月至2008年1月,我科应用无内固定装置技术双束重建ACL损伤患者33例,男31例,女2例。患者排除手术禁忌后,分别在关节镜下采用双股半腱肌腱重建前内侧束,双股股薄肌腱重建后外侧束。韧带采用无内固定装置固定,股骨端行悬吊固定,胫骨端行拴桩固定。术后1~3周内指导患者在支具保护下进行康复训练,并逐渐提高训练强度。结果：术后切口均一期愈合,无并发症。病例随访时间24~48个月,平均36个月。术后12月时：Lysholm评分由术前的52.2±2.5,升至96.4±7.2分,IKDC评分55.3±3.7分,升至94.1±5.3分,其中A级19例,B级：11例。术前与术后Lysholm评分及IKDC评分有显著差别（P〉0.05）。结论：采用无内固定装置双束ACL重建方法能够较好的平衡患者前内侧束和后外侧束张力,并有利于保留ACL韧带残余结构、节约经费,具有令人满意的临床效果。Objective： To evaluate the treating effects of an internal fixation-free technique for the reconstruction of anterior cruci-ate ligament（ACL）.Method： From January 2005 to January 2008,we treated 33 ACL injury patients by an internal fixation-free tech-nique.They were 31 male and 2 female.After surgical contraindications were excluded,all the patients were treated with a novel fixation method.The anteromedial bundle of ACL was reconstructed with semitendinosius and the posterolateral bundle was reconstructed with gracilis.Both the two tendons were fixed by an internal fixation-free technique.The rehabilitation practiced during 1 to 3 weeks after op-eration under the protection of brace.Results： The results of short term follow-up showed that all the cuts were A healing and all the fix-ation were stable.The function of the knee joint was measured by Lysholm and IKDC scores.Pre-operation the average Lysholm score of the patients was 52.2±2.5,and 12 months post-operation the score was raised to 96.4±7.2.And the pre-operation the average IKDC scores of the patients were 55.3±3.7,and 12 months post-operation the score was raised to 94.1±5.3.There were significant differences between the scores of pre-operation and post-operation.Conclusions： The internal fixation-free technique can balance the tension be-tween the anteromedial bundle and posterolateral bundle of ACL without damaging its stump.

关 键 词：前交叉韧带 双束重建 无内固定 关节功能 

分 类 号：R681[医药卫生—骨科学]