摘要
目的探讨髋关节镜对髋关节圆韧带损伤的镜下诊断及治疗作用。方法 2007年6月至2008年2月收治3例术前怀疑圆韧带损伤患者,但MRI及造影检查未能显示出髋关节圆韧带的断裂。3例患者经髋关节镜探查确诊,均为完全断裂,髋臼窝内及股骨头均未见撕脱骨折,韧带组织散乱呈绒毛状,组织间有少量瘢痕及出血、水肿滑膜组织。此外,1例髋臼发育不良患者还合并前外盂唇的磨损。镜下对损伤的圆韧带予以清除,并同时清理关节腔,髋臼发育不良患者对前外侧磨损的盂唇予以修整术。结果随访5～23个月(平均14.8个月)。术后1周,3例患者基本恢复正常关节活动范围;除髋臼发育不良者外,其余患者术后6周腹股沟疼痛症状消失,外展并极度外旋痛阴性。髋臼发育不良患者术后6周仍有较长时间行走后疼痛,术后3个月基本消失。未见血管、神经损伤及皮肤坏死等并发症。结论髋关节镜不仅能准确探查、诊断髋关节圆韧带损伤,而且可同时在髋关节镜下对损伤的髋臼圆韧带进行有效处理。
Objective To introduce the use of arthroscopy in diagnosis and treatment of rupture of the ligamentum teres.Methods From June 2007 to February 2008,3 hips in 3 patients were diagnosed and treated with an arthroscopic procedure for rupture of the ligamentum teres.MRI and opacification did not show obvious rupture,though rupture of the ligamentum teres was suspected.Rupture of the ligamentum teres was ensured by arthroscopy and arthroscopic debridment was operated in all patients.Results No avulsion fracture was discovered in femoral head or acetabulum,and acetabular labral tear was debridment in the patient with DDH.At an average follow-up of 14.8months（5-23 months）,two patients experienced pain relief and were free of symptoms at 6 weeks after surgery and the patient with DDH had pain of pain after long-distance walking until post-operative 3 months.There was no complication in this series.Conclusion Arthroscopy is useful to diagnose and treat rupture of the ligamentum,while rupture of the ligamentum is rare and difficult to cure.Arthroscopic surgery appears to be satisfactory management with less surgical morbidity,earlier rehabilitation and improved visualization.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第19期2550-2552,共3页
Chongqing medicine
基金
国家自然科学基金资助项目(30901576/H0609)
关键词
髋关节
圆韧带
关节镜
hip
ligamentum teres
arthroscopy
