Segond骨折的诊治分析  

Analysis of diagnosis and treatment of Segond fracture

作　　者：李明亮[1] 林谋明 周崇斌[1] 王济纬[1] 

机构地区：[1]丽水市人民医院骨科,浙江丽水323000 [2]缙云县田氏伤科医院,浙江丽水323000

出　　处：《中国骨伤》2013年第10期857-860,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨Segond骨折的临床特点和手术治疗的方法与时机。方法：自2008年6月至2011年12月收治16例Segond骨折，6例于伤后1周内行关节镜探查发现前交叉韧带完全断裂，半月板损伤；10例于伤后8～10周行关节镜探查，发现4例前后交叉韧带完全断裂，4例前交叉韧带完全断裂，2例前交叉韧带部分断裂，其中前交叉韧带完全断裂的8例合并半月板损伤，前交叉韧带不全断裂的1例半月板未见明显损伤，1例合并腓骨头骨折与外侧副韧带损伤。所有交叉韧带完全断裂和不全断裂的患者在关节镜探查后行交叉韧带重建术，5例半月板损伤患者行半月板缝合或成形术。术后采用Lysholm—Gillquist膝关节评分进行疗效评定。结果：伤后1周内行手术治疗的6例术后3d时膝关节肿胀明显，关节腔穿刺抽吸有淡血性液抽出，术后1周时始佩戴护具下床活动。伤后8-10周内行手术治疗的10例术后3d时膝关节无明显肿胀，关节腔穿刺抽吸无淡血性液抽出，术后3d即佩戴护具下床活动。所有患者术后获随访，时间12—50个月，平均24个月。术后Lysholm—Gillquist膝关节评分高于术前。所有病例获得满意效果。结论：Segond骨折常合并前交叉韧带损伤和半月板损伤，早期正确诊断对治疗十分重要，关节镜下行交叉韧带重建及半月板修复的最佳手术时间宜在术后8-10周内进行。Objective：To investigate the clinical characteristics of Segond fracture and its operative method and opportu- nity. Methods：From June 2008 to December 2011, arthroscopic exploration was performed in 16 patients with Segond fracture. Six patients were explored at 1 week after injury,their anterior cruciate ligament were broken completely combined with meniscus injury. Ten patients were explored at 8-10 weeks after injury, 4 patients with anterior and posterior cruciate ligament breakage completely, 4 patients with anterior cruciate ligament breakage completely, and 2 patients with anterior cruciate liga- ment breakage incompletely ,among 10 cases, 8 cases of anterior cruciate ligament breakage completely combined with menis- cus injury, 1 case of anterior cruciate ligament breakage incompletely without obviously meniscus injury, 1 case combined with fibular head fracture and lateral collateral ligament injury. All broken cruciate ligaments were rebuilt after arthroscopic explo- ration and meniscus injuries were sutured in 5 cases. Clinical effects were evaluated according to Lysholm-Gillquist scoring of knee joint function. Results： Six patients were operated at 1 week after injury, their knee joint swelled obviously at 3 days after operation, unloaded blood oozing by joint puncture, and out-of-bed activity with assistance at the 1 week after operation. Other 10 patients were operated at 8-10 weeks after injury, no knee joint obviously swelled, no blood oozing was found by joint punc- ture, and out-of-bed activity with assistance at 3 days after operation. All patients were followed up from 12 to 50 months with an average of 24 months. Postoperative Lysholm-Gillquist scoring of all patients were higher than preoperative and recovered well. Conclusion： Segond fractures often associated with anterior cruciate ligament breakage and meniscus injury, it is impor- tant that early detection for treatment. The best time of cruciate ligament rebuilding and meniscus repairing may be at 8-10 weeks after injury.

关 键 词：SEGOND骨折 前交叉韧带 半月板 胫骨 

分 类 号：R683.42[医药卫生—骨科学]