[1]陈帅,严海霞,张宏艺,等.关节镜下“川”字形三针全内垂直缝合技术治疗膝关节内侧半月板桶柄状撕裂[J].中医正骨,2023,35(03):73-77,80.
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关节镜下“川”字形三针全内垂直缝合技术治疗膝关节内侧半月板桶柄状撕裂()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年03期
页码:
73-77,80
栏目:
临床报道
出版日期:
2023-03-20

文章信息/Info

作者:
陈帅1; 严海霞2; 张宏艺1; 焦锋1
(1.广州市中西医结合医院,广东 广州 510800; 2.广州中医药大学,广东 广州 510405)
关键词:
膝损伤;  半月板;  关节镜检查;  缝合技术
摘要:
目的:观察关节镜下“川”字形三针全内垂直缝合技术治疗膝关节内侧半月板桶柄状撕裂(bucket-handle tear of the medial meniscus,BHTMM)的临床疗效和安全性。方法:2016年6月至2021年6月,采用关节镜下“川”字形三针全内垂直缝合技术治疗膝关节BHTMM患者39例。男23例,女16例。年龄18～55岁,中位数29岁。左膝18例,右膝21例。新鲜损伤26例,陈旧损伤13例。所有患者均表现为膝关节疼痛、酸软无力、交锁、屈曲或伸直受限等; 体格检查均显示膝关节内侧间隙压痛,麦氏征和半月板研磨试验阳性; 膝关节X线检查均显示膝关节骨质无异常或有轻微退变; 膝关节MRI检查均显示冠状位上“分离征”,矢状位上“双后交叉韧带征”。BHTMM长度(43.87±4.40)mm。病程1～48周,中位数6周。记录手术时间。术前和末次随访时,测量膝关节活动度,采用Lysholm膝关节评分标准评价膝关节功能,采用《半月板损伤诊疗与康复》中半月板损伤的MRI影像学评价标准和疗效评价标准评价半月板愈合情况和临床疗效。术后随访观察并发症发生及二次手术情况。结果:本组患者均顺利完成手术,手术时间30～90 min,中位数40 min; 均获随访,随访时间3～48个月,中位数12个月。末次随访时,39例患者的膝关节活动度大于术前(102.62°±11.96°,124.10°±6.30°,Z=-5.431,P=0.000),Lysholm评分高于术前[(55.10±9.49)分,(87.46±5.32)分,Z=-5.445,P=0.000],半月板完全愈合28例、部分愈合8例、未愈合3例,显效28例、有效10例、无效1例。1例患者术后6个月内膝关节内侧疼痛、交锁、极度屈曲受限,经康复训练后症状逐渐消失。所有患者均无膝关节感染、关节粘连、下肢深静脉血栓形成等并发症发生,均未行二次关节镜手术。结论:关节镜下“川”字形三针全内垂直缝合技术治疗膝关节BHTMM,手术时间短,创伤小,半月板愈合好,能增加膝关节活动度、改善膝关节功能,疗效确切,且并发症少。

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备注/Memo

备注/Memo:
基金项目:广东省中医师承“薪火工程”项目(粤中医办〔2021〕5号); 广州市科技计划项目(202201010864)
通讯作者:焦锋 E-mail:doctor_jiaofeng@126.com
更新日期/Last Update: 1900-01-01