[1]李前,陈绍军,李岗,等.“8”字悬吊法重建外侧副韧带及腘腓韧带治疗膝关节多发韧带损伤[J].中医正骨,2017,29(03):49-51,55.
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“8”字悬吊法重建外侧副韧带及腘腓韧带治疗膝关节多发韧带损伤()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年03期
页码:
49-51,55
栏目:
临床报道
出版日期:
2017-03-20

文章信息/Info

作者:
李前1陈绍军1李岗1徐昭乐1钟佳1邵先舫1刘志军1张晋2
1.湖南省常德市第一中医医院,湖南 常德 415000; 2.北京积水潭医院,北京 100035
关键词:
膝关节 关节镜检查 侧副韧带 腘腓韧带 前交叉韧带 后交叉韧带 内侧副韧带
摘要:
目的:观察“8”字悬吊法重建外侧副韧带(lateral collateral ligament,LCL)及腘腓韧带(popliteofibular ligament,PFL)治疗膝关节多发韧带损伤的临床疗效及安全性。方法:2013年1月至2015年1月,采用“8”字悬吊法重建LCL及PFL治疗膝关节多发韧带损伤患者21例,男16例、女5例。年龄18~63岁,中位数48岁。均为闭合性损伤,左膝12例、右膝9例。单纯膝关节后外复合体(posterolateral corner,PLC)损伤2例,PLC损伤伴前交叉韧带(anterior cruciate ligament,ACL)损伤3例,PLC损伤伴后交叉韧带(posterior cruciate ligament,PCL)损伤9例,PLC损伤伴ACL及PCL损伤4例,PLC损伤伴PCL及内侧副韧带(medial collateral ligament,MCL)损伤2例,PLC损伤伴ACL、PCL及MCL损伤1例。PLC损伤根据Fanelli分型标准,A型1例、B型2例、C型18例。受伤至手术时间16~41 d,中位数34 d。术后随访观察胫骨外旋程度、膝关节外侧间隙张开程度、膝关节功能恢复及并发症发生情况。结果:所有患者均获随访,随访时间16~38个月,中位数25个月。胫骨外旋程度,术前15.9°±4.0°、末次随访时-1.8°±3.3°。膝关节外侧间隙张开程度,术前(12.4±2.6)mm、末次随访时(4.2±1.6)mm。术后3个月随访时,2例患者屈膝角度为90°,于麻醉状态下行松解手术后恢复正常; 末次随访时,所有患者屈膝角度均>120°。国际膝关节文献委员会评分,术前(58.1±3.7)分、末次随访时(88.1±1.6)分。1例伴MCL损伤患者出现伸膝受限约5°,2例伴PCL损伤患者出现膝关节后外侧疼痛,1例伴MCL损伤患者出现MCL股骨止点异位骨化,1例伴ACL损伤患者Lachman试验阳性伴硬性终止点,2例伴PCL损伤患者后抽屉试验阳性伴硬性终止点。所有患者均未出现感染、下肢深静脉血栓形成及膝关节错动感。结论:“8”字悬吊法重建LCL及PFL治疗膝关节多发韧带损伤,能够降低胫骨外旋程度及膝关节外侧间隙张开程度,促进膝关节功能恢复,且安全性较高,值得临床推广应用。

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更新日期/Last Update: 1900-01-01