目的综述膝关节脱位(knee dislocation,KD)后内侧结构及后外侧角损伤分期分型及诊治的研究进展,以期为临床工作提供指导。方法广泛查阅近年国内外相关KD后内侧结构及后外侧角的分期分型及诊断、治疗文献,并进行总结。结果目前临床KD分...目的综述膝关节脱位(knee dislocation,KD)后内侧结构及后外侧角损伤分期分型及诊治的研究进展,以期为临床工作提供指导。方法广泛查阅近年国内外相关KD后内侧结构及后外侧角的分期分型及诊断、治疗文献,并进行总结。结果目前临床KD分型标准主要有根据受伤能量大小分型、Kennedy分型、改良Schenck分型,但均不完善;未对KD中的多发韧带损伤进行分期、分型,也未针对不同损伤分型提出规范治疗方案。而KD多发韧带损伤华西分期分型(Hua Xi Knee Dislocation and Multiple Ligament Injury,HX-KDMLI)诊断及规范化治疗体系对后内侧结构及后外侧角损伤进行分期、分型,并提出针对性治疗方案。结论目前关于KD后内侧结构、后外侧角损伤的分期分型诊断与治疗仍无统一意见,HX-KDMLI体系对以上两方面进行了系统描述,对KD的诊治具有一定参考价值。展开更多
Background: Injuries to the posterolateral corner of the knee (PLC) can be difficult to diagnose and are often missed. The prone dial test can be difficult to perform in the acute setting and the supine dial test requ...Background: Injuries to the posterolateral corner of the knee (PLC) can be difficult to diagnose and are often missed. The prone dial test can be difficult to perform in the acute setting and the supine dial test requires an assistant. Purpose: We present a simple single person seated dial test that can easily be performed in all patients with a suspected diagnosis of PLC injury. Study Design: Case Series. Method: The patient is seated on the edge of the examination couch with their knees flexed over the side and their calves pressed against the couch to reduce any posterior tibial subluxation. The patients’ knees are placed together ensuring the pelvis is square;the knees are at the same level, and the patellae are facing anteriorly. The patients place their hands against the side of their knees and hold their knees together in this position. The examiner then grasps the patient’s feet, approximates the medial malleoli and exerts a lateral rotational force at 30 and 90 degrees of knee flexion. Results: This test has 100% accuracy for diagnosing PLC injury in our institution. Conclusion: We present a sample to use alternative to traditional dial testing that does not require an assistant and also does not require the patient to be prone, thus limiting discomfort in the acute setting.展开更多
A patient with both a femoral attachment injury （peel-off injury） and musculotendinous junction avulsion of the popliteus, a so-called ＂floating popliteus tendon injury＂, received arthroscopy-assisted popliteus re...A patient with both a femoral attachment injury （peel-off injury） and musculotendinous junction avulsion of the popliteus, a so-called ＂floating popliteus tendon injury＂, received arthroscopy-assisted popliteus reconstruction. The injured ligaments were addressed in the same procedure, including mini-open direct repair of the femoral avulsed fibular collateral ligament （FCL）, suture repair of the grade 3 medial collateral ligament （MCL）, and reconstruction of the posterior cruciate ligament （PCL~.展开更多
文摘目的综述膝关节脱位(knee dislocation,KD)后内侧结构及后外侧角损伤分期分型及诊治的研究进展,以期为临床工作提供指导。方法广泛查阅近年国内外相关KD后内侧结构及后外侧角的分期分型及诊断、治疗文献,并进行总结。结果目前临床KD分型标准主要有根据受伤能量大小分型、Kennedy分型、改良Schenck分型,但均不完善;未对KD中的多发韧带损伤进行分期、分型,也未针对不同损伤分型提出规范治疗方案。而KD多发韧带损伤华西分期分型(Hua Xi Knee Dislocation and Multiple Ligament Injury,HX-KDMLI)诊断及规范化治疗体系对后内侧结构及后外侧角损伤进行分期、分型,并提出针对性治疗方案。结论目前关于KD后内侧结构、后外侧角损伤的分期分型诊断与治疗仍无统一意见,HX-KDMLI体系对以上两方面进行了系统描述,对KD的诊治具有一定参考价值。
文摘Background: Injuries to the posterolateral corner of the knee (PLC) can be difficult to diagnose and are often missed. The prone dial test can be difficult to perform in the acute setting and the supine dial test requires an assistant. Purpose: We present a simple single person seated dial test that can easily be performed in all patients with a suspected diagnosis of PLC injury. Study Design: Case Series. Method: The patient is seated on the edge of the examination couch with their knees flexed over the side and their calves pressed against the couch to reduce any posterior tibial subluxation. The patients’ knees are placed together ensuring the pelvis is square;the knees are at the same level, and the patellae are facing anteriorly. The patients place their hands against the side of their knees and hold their knees together in this position. The examiner then grasps the patient’s feet, approximates the medial malleoli and exerts a lateral rotational force at 30 and 90 degrees of knee flexion. Results: This test has 100% accuracy for diagnosing PLC injury in our institution. Conclusion: We present a sample to use alternative to traditional dial testing that does not require an assistant and also does not require the patient to be prone, thus limiting discomfort in the acute setting.
基金the grants from the National Natural Science Foundation of China，Capital Development Fund of Medical Research
文摘A patient with both a femoral attachment injury （peel-off injury） and musculotendinous junction avulsion of the popliteus, a so-called ＂floating popliteus tendon injury＂, received arthroscopy-assisted popliteus reconstruction. The injured ligaments were addressed in the same procedure, including mini-open direct repair of the femoral avulsed fibular collateral ligament （FCL）, suture repair of the grade 3 medial collateral ligament （MCL）, and reconstruction of the posterior cruciate ligament （PCL~.
