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ID:19683210
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时间:2018-10-04
《关节镜下膝前交叉韧带与后交叉韧带联合重建 》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、关节镜下膝前交叉韧带与后交叉韧带联合重建孙磊,宁志杰,田敏,宁廷民,张红,罗毅,马清元,高加智,刘欣欣【关键词】前交叉韧带摘要:〔目的〕探讨膝关节双交叉韧带损伤的临床特点,评估关节镜下前交叉韧带(ACL)与后交叉韧带(PCL)联合重建的技术和效果。〔方法〕自2001年9月~2005年2月,13例病人(13膝)经关节镜检查证实ACL和PCL均断裂,其中5膝伴后内侧角(PMC)、内侧副韧带损伤(MCL),4膝伴后外侧角损伤(PLC),2膝伴外侧半月板破裂,1膝伴内侧半月板损伤,3膝伴动脉损伤,2膝伴腓总
2、神经损伤。7例病人于损伤后急性期入院,2膝于急性期行血管探查修复,4膝行膝后内侧角、内侧副韧带修复。13例病人于伤后4~12周在关节镜下行自体移植物单束ACL和PCL联合重建术,其中4例同期后1/2股二头肌腱重建后PLC,1例同期阔筋膜PMC、MCL重建。〔结果〕本组术后早期均未发生严重并发症。术后随访10~39个月,平均(2185±928)个月,Lysholm膝关节功能评分为75~95分,平均(8654±689)分。国际膝关节文件编制委员会(IKDC)综合评定由术前显著异常(D级)13例,改进为随
3、访时正常(A级)3例、接近正常(B级)8例、异常(C级)2例。13例病人中,11例恢复至伤前运动水平,2例运动水平较伤前减低。〔结论〕膝关节双交叉韧带损伤多伴有其它重要结构损伤,需妥善处理合并损伤。关节镜下自体移植物联合单束重建ACL和PCL创伤小、手术操作精细,术后膝关节功能恢复满意。关键词:膝关节;前交叉韧带;后交叉韧带;关节镜;四股绳肌腱;单束重建Abstract:〔Objective〕Toexploretheclinicalcharacteristicsofbicruciateligamen
4、tinjuryoftheknee,evaluatethetechniqueandouteofarthroscopicbinedreconstructionofanteriorcruciateligament(ACL)andposteriorcruciateligament(PCL)Sept2001toFeb2005,13knees,5kneeedialconer(PMC)andmedialcollateralligament(MCL),3binedeniscustear,1edialmeniscus
5、tear,3associatedittedintothisdepartmentinacutephaseoftrauma,repairofpoplitealarteryin2patientsandrepairofPMCandMCLin4patientsedinthisphase.ArthroscopicbinedreconstructionofACLandPCLedinallpatientsfrom4to12a,reconstructionofPLCoristendontenodesisin3pati
6、entsandreconstructionofPMCandMCLoralfasciain1patientultaneously.〔Result〕Nosevereplicationsoccurredinearlystageafteroperationinthe13patients.Allofthem10to39monthsonths.Lysholmscoreore,thereprovementinIKDCscorefromseverelyabnormal(gradeD)in13kneepreopera
7、tivelytonormal(gradeA)in3knees,nearlynormal(gradeB)in8kneesandabnormalin2kneesatfolloesportslevelbeforeinjuryand3enttearofthekneeisusuallybinedportantstructuredamages,andcarefulassessmentandtreatmentofthebinedinjuriesareessential.Arthroscopicbinedrecon
8、structionofACLandPCLinimaltraumainsurgeryandreliablesatisfactoryoute.Keyent(ACL);Posteriorcruciateligament(PCL);Arthroscopy;Quadrupledhamstringtendons;Singlebundlereconstruction膝关节前交叉韧带(anteriorcruciateligament,ACL)和后交叉韧带(posteriorcruci
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