中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
35期
2460-2462
,共3页
前交叉韧带%膝损伤%修复外科手术%移植,自体
前交扠韌帶%膝損傷%脩複外科手術%移植,自體
전교차인대%슬손상%수복외과수술%이식,자체
Anterior cruciate ligament%Knee injuries%Reconstruction surgical procedures%Transplantation,autologous
目的 探讨腓骨长肌重建前交叉韧带的可行性,观察其临床治疗效果及取腓骨长肌对踝关节功能的影响.方法 自2006年1月至2009年12月收治前交叉韧带损伤患者35例,男30例,女5例,年龄21 ～ 56岁,平均31.8岁.交叉韧带损伤均在C型臂透视下微创操作,手术均取自体腓骨长肌重建前交叉韧带,重建韧带用可吸收螺钉挤压固定.术后评估包括临床检查,Lysholm评分,KT-3000测试,美国足踝外科学会(AOFAS)评分.结果 35例患者全部获得随访,随访时间12 ～ 24个月,平均15个月.根据Lysholm评分标准其中优25例,良6例,可3例,差1例,Lysholm评分均为60 ～100分,平均97.2分,优良率为88.6％,膝关节功能术前与术后末次随访比较差异有统计学意义(P＜0.05).KT-3000测量正常28例,接近正常4例,异常2例,差1例,术前膝关节平均前移为(11.6±1.3) mm,术后末次检查平均值为(1.8±1.8)mm.术前术后比较差异有统计学意义(P＜0.05).AOFAS评分为84 ～ 100分,平均96.3分,术前与术后末次随访差异无统计学意义(P＞0.05).结论腓骨长肌可以作为前交叉韧带的移植替代物,切取腓骨长肌后对踝关节功能无明显影响.
目的 探討腓骨長肌重建前交扠韌帶的可行性,觀察其臨床治療效果及取腓骨長肌對踝關節功能的影響.方法 自2006年1月至2009年12月收治前交扠韌帶損傷患者35例,男30例,女5例,年齡21 ～ 56歲,平均31.8歲.交扠韌帶損傷均在C型臂透視下微創操作,手術均取自體腓骨長肌重建前交扠韌帶,重建韌帶用可吸收螺釘擠壓固定.術後評估包括臨床檢查,Lysholm評分,KT-3000測試,美國足踝外科學會(AOFAS)評分.結果 35例患者全部穫得隨訪,隨訪時間12 ～ 24箇月,平均15箇月.根據Lysholm評分標準其中優25例,良6例,可3例,差1例,Lysholm評分均為60 ～100分,平均97.2分,優良率為88.6％,膝關節功能術前與術後末次隨訪比較差異有統計學意義(P＜0.05).KT-3000測量正常28例,接近正常4例,異常2例,差1例,術前膝關節平均前移為(11.6±1.3) mm,術後末次檢查平均值為(1.8±1.8)mm.術前術後比較差異有統計學意義(P＜0.05).AOFAS評分為84 ～ 100分,平均96.3分,術前與術後末次隨訪差異無統計學意義(P＞0.05).結論腓骨長肌可以作為前交扠韌帶的移植替代物,切取腓骨長肌後對踝關節功能無明顯影響.
목적 탐토비골장기중건전교차인대적가행성,관찰기림상치료효과급취비골장기대과관절공능적영향.방법 자2006년1월지2009년12월수치전교차인대손상환자35례,남30례,녀5례,년령21 ～ 56세,평균31.8세.교차인대손상균재C형비투시하미창조작,수술균취자체비골장기중건전교차인대,중건인대용가흡수라정제압고정.술후평고포괄림상검사,Lysholm평분,KT-3000측시,미국족과외과학회(AOFAS)평분.결과 35례환자전부획득수방,수방시간12 ～ 24개월,평균15개월.근거Lysholm평분표준기중우25례,량6례,가3례,차1례,Lysholm평분균위60 ～100분,평균97.2분,우량솔위88.6％,슬관절공능술전여술후말차수방비교차이유통계학의의(P＜0.05).KT-3000측량정상28례,접근정상4례,이상2례,차1례,술전슬관절평균전이위(11.6±1.3) mm,술후말차검사평균치위(1.8±1.8)mm.술전술후비교차이유통계학의의(P＜0.05).AOFAS평분위84 ～ 100분,평균96.3분,술전여술후말차수방차이무통계학의의(P＞0.05).결론비골장기가이작위전교차인대적이식체대물,절취비골장기후대과관절공능무명현영향.
Objective To evaluate the effects of anterior cruciate ligament reconstruction with peroneus longus tendon and observe the clinical outcomes of ankle joint after the resection of peroneus longus tendon.Methods From January 2006 to December 2009,35 patients with anterior cruciate ligament injuries were recruited to undergo surgical procedures.There were 30 males and 5 females with an average age of 31.8 years (range:21-56).All anterior cruciate ligament reconstructions underwent arthrosocopy.All ligaments were reconstructed with peroneus longus tendon and fixed with absorb screw.The post-operative assessments included the followings:clinical evaluations,Lysholm knee score,KT-3000 arthrometer evaluation and the American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS).Results All cases were followed up for an average follow-up period of 15 months (range:12-24).The healing time was 6-15 weeks.according to the Lysholm knee score,their outcomes were excellent ( n =25 ),good ( n =6),fair ( n =3 ) and poor ( n =1 ).The average score was 97.2 ( range:60-100).The rate of excellent and good was 88.6％ ; according to the KT-3000 arthrometer evaluations,the outcomes were normal (n =28 ),nearly normal ( n =4),abnormal ( n =2) and poor ( n =1 ).Preoperatively,the average anterior displacement was 11.59 ± 1.25 mm and the average anterior displacement at final follow-up 1.76 ± 1.83 mm.The average AOFAS score was 96.3 (range:84-100).Lysholm knee score and KT-3000 arthrometer evaluation had statistical differences (P ＜ 0.05 ) while AOFAS score showed no difference ( P ＞ 0.05).Conclusion Peroneus longus tendon can be a good substitute of anterior cruciate ligament reconstruction.And its resection has no major influence for ankle joint.
