膝关节脱位多韧带损伤Ⅰ期修复重建的临床观察  

Reconstruction for knee dislocation with multiple ligaments injury at stageⅠ

作　　者：邱俊钦[1] 林任[1] 林伟[1] 黄显贵[1] 熊国胜[1] 

机构地区：[1]厦门大学附属福州第二医院,福建福州350007

出　　处：《中国骨伤》2015年第12期1095-1099,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨关节镜下Ⅰ期异体肌腱重建并结合关节外微创技术治疗膝关节脱位合并多发韧带损伤的临床疗效。方法:2008年1月至2012年1月共收治48例膝关节脱位患者,排除腘血管损伤,采用关节镜下Ⅰ期重建前后交叉韧带,并结合关节外微创技术修复膝关节韧带损伤。男38例,女10例;年龄20~59岁,平均35.6岁;左膝22例,右膝26例;伤后至手术时间2 d^2周。前交叉韧带(ACL)、后交叉韧带(PCL)、内侧副韧带(MCL)及后外侧复合体(PLC)损伤2例,ACL、PCL及MCL损伤36例,ACL、PCL及PLC损伤10例。合并腓总神经损伤4例。比较术前及末次随访时Lysholm评分以评价膝关节功能。结果:所有患者获得随访,时间12~30个月,平均(18.2±6.3)个月,患者关节活动度和稳定性明显改善,Lysholm评分由术前40.3±4.1提高为随访时87.0±6.4。结论:关节镜下应用同种异体肌腱Ⅰ期重建膝关节脱位并多韧带损伤,能较好地恢复关节稳定性,保留关节功能。术前训练指导及术后个体化康复是膝关节功能恢复的关键。Objective：To investigate clinical outcomes of tendon allograft reconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury. Methods：Forty eight patients with knee dislocation were reconstructed anterior and posterior ligament under arthroscopy at stage I from January 2008 to January2012,and repaired ligaments injury of knee joint by minimally invasive technique. There were 38 males and 10 females aged from 20 to 59 years old with an average of 35.6 years old;22 cases on the left side and 26 cases on the right side;the time from injury to operation ranged from 2 d to 2 weeks. Two cases combined with anterior cruciate ligament（ACL）,posterior cruciate ligament（PCL）,medial collateral ligament（MCL） and posterolateral complex injuries,36 cases combined with ACL,PCL,and MCL injuries,10 cases combined with ACL,PCL and PLC injuries; 4 cases combined with peroneal nerve injury. Lysholm scoring were used to compared the cases before operation and final following up to evaluate knee function. Results：All patients were followed up from 12 to 30 months with an average of（18.2±6.3） months. Activity and stability of joint were obviously improved. Lysholm score were improved from 40.3±4.1 before operation to 87.0±6.4 at final following-up. Conclusion：Reconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury could recover stability of joint better,reserve joint function. Preoperative training and postoperative individualized rehabilitation treatment is the key point of recover knee joint function.

关 键 词：膝关节 脱位 关节镜 韧带 

分 类 号：R686.5[医药卫生—骨科学]