中华骨与关节外科杂志
中華骨與關節外科雜誌
중화골여관절외과잡지
Chinese Journal Bone and Joint Surgery
2015年
2期
101-103
,共3页
王江涛%刘玉杰%曲峰%袁邦拓%肇刚%申学振%朱娟丽%刘洋
王江濤%劉玉傑%麯峰%袁邦拓%肇剛%申學振%硃娟麗%劉洋
왕강도%류옥걸%곡봉%원방탁%조강%신학진%주연려%류양
前交叉韧带损伤%半月板损伤%治疗
前交扠韌帶損傷%半月闆損傷%治療
전교차인대손상%반월판손상%치료
Anterior cruciate ligament injury%Meniscus injury%Repair
背景:前交叉韧带合并半月板损伤临床常见,针对不同的损伤类型,采取不同的治疗策略,对术后膝关节功能恢复至关重要。目的:研究前交叉韧带合并半月板不同损伤类型的特点,探讨相应的治疗策略。<br> 方法:选取2005年10月至2013年12月期间收治的前交叉韧带合并半月板损伤患者139例,男98例,女41例;年龄13~71岁,平均31.2岁;左膝62例,右膝77例,病程5 d至1.6年,陈旧性损伤(病程>3周)32例,新鲜性损伤(病程≤3周)107例。患者均有外伤史。临床主要表现为膝关节不稳、疼痛、弹响、绞锁。将术中镜下影像资料进行分析,统计前交叉韧带合并半月板损伤的类型特征及手术方式。<br> 结果:所有病例均采用关节镜微创手术治疗,前交叉韧带完全断裂113例,部分断裂26例。外侧半月板损伤46例(盘状半月板损伤8例,胫骨髁间棘撕脱2例)占33.1%,内侧半月板损伤65例(46.7%),内外侧半月板同期损伤28例(20.2%)。半月板纵行撕裂42例(桶柄状撕裂24例),水平状撕裂8例,斜行撕裂36例,瓣状撕裂13例,横断性撕裂12例,复合性撕裂28例。前交叉韧带重建139例,半月板部分切除36例,半月板缝合103例。<br> 结论:陈旧性前交叉韧带合并半月板损伤以外侧半月板多见,急性损伤以内侧半月板损伤为主。内外侧半月板同期损伤多见于陈旧性损伤。陈旧性损伤多数需要半月板部分切除,急性损伤多数可以缝合。前交叉韧带合并半月板损伤应早期手术。
揹景:前交扠韌帶閤併半月闆損傷臨床常見,針對不同的損傷類型,採取不同的治療策略,對術後膝關節功能恢複至關重要。目的:研究前交扠韌帶閤併半月闆不同損傷類型的特點,探討相應的治療策略。<br> 方法:選取2005年10月至2013年12月期間收治的前交扠韌帶閤併半月闆損傷患者139例,男98例,女41例;年齡13~71歲,平均31.2歲;左膝62例,右膝77例,病程5 d至1.6年,陳舊性損傷(病程>3週)32例,新鮮性損傷(病程≤3週)107例。患者均有外傷史。臨床主要錶現為膝關節不穩、疼痛、彈響、絞鎖。將術中鏡下影像資料進行分析,統計前交扠韌帶閤併半月闆損傷的類型特徵及手術方式。<br> 結果:所有病例均採用關節鏡微創手術治療,前交扠韌帶完全斷裂113例,部分斷裂26例。外側半月闆損傷46例(盤狀半月闆損傷8例,脛骨髁間棘撕脫2例)佔33.1%,內側半月闆損傷65例(46.7%),內外側半月闆同期損傷28例(20.2%)。半月闆縱行撕裂42例(桶柄狀撕裂24例),水平狀撕裂8例,斜行撕裂36例,瓣狀撕裂13例,橫斷性撕裂12例,複閤性撕裂28例。前交扠韌帶重建139例,半月闆部分切除36例,半月闆縫閤103例。<br> 結論:陳舊性前交扠韌帶閤併半月闆損傷以外側半月闆多見,急性損傷以內側半月闆損傷為主。內外側半月闆同期損傷多見于陳舊性損傷。陳舊性損傷多數需要半月闆部分切除,急性損傷多數可以縫閤。前交扠韌帶閤併半月闆損傷應早期手術。
배경:전교차인대합병반월판손상림상상견,침대불동적손상류형,채취불동적치료책략,대술후슬관절공능회복지관중요。목적:연구전교차인대합병반월판불동손상류형적특점,탐토상응적치료책략。<br> 방법:선취2005년10월지2013년12월기간수치적전교차인대합병반월판손상환자139례,남98례,녀41례;년령13~71세,평균31.2세;좌슬62례,우슬77례,병정5 d지1.6년,진구성손상(병정>3주)32례,신선성손상(병정≤3주)107례。환자균유외상사。림상주요표현위슬관절불은、동통、탄향、교쇄。장술중경하영상자료진행분석,통계전교차인대합병반월판손상적류형특정급수술방식。<br> 결과:소유병례균채용관절경미창수술치료,전교차인대완전단렬113례,부분단렬26례。외측반월판손상46례(반상반월판손상8례,경골과간극시탈2례)점33.1%,내측반월판손상65례(46.7%),내외측반월판동기손상28례(20.2%)。반월판종행시렬42례(통병상시렬24례),수평상시렬8례,사행시렬36례,판상시렬13례,횡단성시렬12례,복합성시렬28례。전교차인대중건139례,반월판부분절제36례,반월판봉합103례。<br> 결론:진구성전교차인대합병반월판손상이외측반월판다견,급성손상이내측반월판손상위주。내외측반월판동기손상다견우진구성손상。진구성손상다수수요반월판부분절제,급성손상다수가이봉합。전교차인대합병반월판손상응조기수술。
Background:Anterior cruciate ligament (ACL) combined with meniscus injuries is a common disease in clinic. It is very im-portant to take different treatment therapies for different types of injury. <br> Objective:To study the features of the combined injury of ACL and meniscus and to explore its treatment strategies <br> Methods:A total of 139 patients with ACL and meniscus injury admitted into our hospital from October 2005 to December 2013. There were 98 males and 41 females with a mean age of 31.2 years (range, 13-71 years). The left knee was affected in 62 cases and the right knee was injured in 77 cases. The course of disease ranged from 5 days to 1.6 years. The injury was chronic (duration>3 weeks) in 32 cases and fresh (duration≤3 weeks) in 107 cases. All patients had a history of trauma. The main clinical manifestations included knee joint instability, pain, joint clicking and locking. The features of injury and the mode of operation were analyzed according to arthroscopic video images. <br> Results:All patients were treated under arthroscopy. There were 113 patients with complete ACL rupture and 26 with partial rupture. The lateral meniscus injury (discoid meniscus injury in 8 cases, tibial eminence fracture in 2) occurred in 46 cases (33.1%). The medial meniscus injury happened in 65 cases (46.7%). The lateral and medial combined injury was found in 28 cases (20.2%). Longitudinal tear was found in 42 cases (bucket-handle tear in 24), horizontal in 8, oblique in 36, flap shaped in 13, cross-sectional in 12, and compound in 28. There were 139 patients treated with ACL reconstruction, 36 with partial meniscectomy, and 103 with meniscus suture repair. <br> Conclusions:Chronic combined injury of ACL and meniscus often occur in lateral meniscus, while acute injury is mainly in medial meniscus. The homochronous injury of medial and lateral meniscuses is often chronic. It usually needs to undergo partial meniscectomy for chronic injuries, and suturing is essential for acute ones. The combined injury of ACL and menis-cus should be treated as early as possible.