摘要
目的探讨创伤性膝关节脱位(KD)失稳性的临床诊治方法及效果。方法选择东莞市石碣医院骨科2012年6月至2015年6月收治的创伤性膝关节脱位失稳性患者30例,给予一期关节镜下前交叉韧带(ACL)、后交叉韧带(PCL)重建+有限切开修复/重建内侧副韧带(MCL)、外侧副韧带(LCL),观察患者治疗前后的膝关节活动度、膝关节功能以及国际膝关节文献委员会(IKDC)评分。结果所有患者术后切口均Ⅰ期愈合且无感染等并发症,术后12个月前抽屉试验、后抽屉试验、Lachman试验及反Lachman试验、内翻应力试验、外翻应力试验均为阴性;患者术后膝关节活动度与Lysholm评分分别为(121.1±6.2)°与(88.45±5.2)分,均显著高于术前的(57.4±5.3)°与(37.4±5.3)分,差异均有显著统计学意义(P<0.01);伤后3周内手术患者膝关节活动度与Lysholm评分分别为(127.1±4.1)°与(89.8±6.2)分,均显著优于伤后3周后手术患者的(117.4±3.2)°与(79.1±5.3)分,差异均有显著统计学意义(P<0.01)。结论一期关节镜下ACL、PCL重建+有限切开修复/重建MCL、LCL并早期系统功能锻炼在KD患者的治疗中创伤小、固定牢、并发症少、康复快、关节功能改善显著,值得临床推广。
Objective To discuss the clinical diagnosis and effects of unstable traumatic knee joint dislocation（KD）. Methods Thirty patients with unstable traumatic KD in Department of Orthopedics in Shijie Hospital of Dongguan City from June 2012 to June 2015 were selected. All patients were treated with arthroscopic anterior cruciate ligament（ACL）, posterior cruciate ligament（PCL） reconstruction, limited open repair/reconstruction of medial collateral ligament（MCL）, and lateral collateral ligament（LCL）. The knee joint activity, knee function and the International Knee Documentation Committee（IKDC） score were observed before and after treatment. Results All patients were healed by primary healing, and no infection and other complications occured. The anterior drawer test, posterior drawer test,Lachman test and the anti-Lachman test, the inverted stress test and the stress test were all negative 12 months after operation. The score of knee joint activity and Lysholm after operation were respectively（121.1 ± 6.2）° and（88.45 ± 5.2）,which were significantly higher than（57.4±5.3）° and（37.4±5.3） before the operation（P〈0.01）. The score of knee joint activity and Lysholm in patients undergoing surgery within 3 weeks after injury were respectively（127.1 ± 4.1）° and（89.8±6.2）, which were significantly better than（117.4±3.2）° and（79.1±5.3） in patients undergoing surgery 3 weeks after injury（P〈0.01）. Conslusion One-stage arthroscopic ACL, PCL reconstruction and limited open repair/reconstruction of MCL, LCL has small trauma, firm fixation, less complications, fast recovery, and significant improvement in joint function in the treatment of patients with KD, which is worthy of promotion.
出处
《海南医学》
CAS
2017年第11期1755-1758,共4页
Hainan Medical Journal
基金
广东省东莞市医疗卫生单位科技计划一般项目立项(编号:2016105101253)
关键词
创伤性
膝关节
脱位
失稳性
疗效
Traumatic
Knee joint
Dislocation
Unstable
Curative effect
