膝关节脱位的早期诊断及微创治疗方法

doi:10.13418/j.issn.1001-165x.2017.05.016

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (5): 559-563.doi: 10.13418/j.issn.1001-165x.2017.05.016

膝关节脱位的早期诊断及微创治疗方法

刘海龙¹，　丁晶²，　甘煜东³

1.云南省公安边防总队医院骨科，昆明 650000；　2.解放军昆明总医院附属骨科医院，昆明 650032；
3.山东大学齐鲁医院（青岛）骨科中心，山东青岛 266035

收稿日期:2017-05-30 出版日期:2017-09-25 发布日期:2017-10-30
通讯作者: 甘煜东，医学博士，博士后，E-mail：gasbzh-1981@163.com
作者简介:共同第一作者：刘海龙（1978-），男，安徽庐江人，主治医师，主要从事创伤骨科研究，Tel：15912116732，E-mail：19045848@qq.com；丁晶（1967-），男，云南石屏人，医学博士，副主任医师，主要从事关节外科与运动医学方面的研究，Tel：13116293553，E-mail：dingxiaoerr@tom.com

The early diagnosis of knee dislocation and its minimally invasive treatment methods

LIU Hai-long¹, DING Jing², GAN Yu-dong³

1. Department of Orthopedics, Yunnan Provincial Public Security Frontier Defense Corps Hospital, Kunming 650000; 2. Orthopedics Hospital Affiliated to Kunming General Hospital, PLA, Kunming 650032, China; 3. Center of Orthopedics, Qilu Hospital of Shandong University, Qingdao 266035, China

Received:2017-05-30 Online:2017-09-25 Published:2017-10-30

摘要/Abstract

摘要：

目的　探讨膝关节脱位的早期诊断及微创治疗。方法　回顾性分析2011年7月~2015年10月收治的90例创伤性膝关节脱位患者，一期行关节镜下韧带重建术，关节囊不予修复，腘动脉损伤修复后推迟3周进行韧带重建，若小腿肌肉已坏死，则取胫骨前肌肌腱或跟腱进行韧带重建，神经行探查、松解或缝合术，Lysholm膝关节评分来评价手术前、后膝关节功能。结果　本组90例患者中，78例获得随访，平均随访时间为18个月（9~24个月）。末次随访膝关节功能Lysholm评分为78~91分，平均85.6分。前后抽屉试验I°阳性各75例，Lachman试验I°阳性75例，内外翻试验均阴性，3例腘动脉损伤导致小腿肌肉坏死者术后出现Ⅱ°松弛1例，Ⅲ°松弛2例。结论　物理与影像学检查对判断创伤性膝关节脱位有积极意义，单纯一期膝关节多发韧带损伤重建的方法可行，近期疗效满意。

关键词: 膝关节, 　脱位, 　关节镜, 　交叉韧带, 　修复重建

Abstract:

Objective　To investigate the early diagnosis and minimally invasive treatment of knee dislocation.　Methods　Retrospective analysis of 90 cases of traumatic knee dislocation from July 2011 to October 2015 were performed. Arthroscopic reconstruction of the ligament was performed, the joint capsule was not repaired and the popliteal artery was repaired for 3 weeks. If the calf muscles have necrosis, then the tibialis tendon or Achilles tendon was used for ligament reconstruction nerve exploration, release or suture surgery was carried out. Lysholm knee score was adopted for evaluation of the knee function before and after surgery. 　Results　Of the 90 patients, 78 were followed up for an average of 18 months (9 to 24 months). The Lysholm score for the last follow-up knee function was 78 to 91, with an average of 85.6 points. 75 cases of drawer test and Lachman test was Ⅰ° positive, and all of the internal and external tests were negative; 3 cases of calf muscle underwent necrosis caused by popliteal artery injury: a Ⅱ° relaxation in 1 case, Ⅲ° relaxation in 2 cases.　Conclusion　Physical and imaging examinations have a positive effect on the diagnosis of traumatic knee dislocation. The one-stage reconstruction of knee ligament injury is feasible, which can lead to a satisfactory short-term curative effect.

Key words: Knee, 　Dislocation, 　Arthroscopy；　Cruciate ligament, 　Repair and reconstruction

刘海龙,丁晶,甘煜东. 膝关节脱位的早期诊断及微创治疗方法[J]. 中国临床解剖学杂志, 2017, 35(5): 559-563.

LIU Hai-long, DING Jing, GAN Yu-dong. The early diagnosis of knee dislocation and its minimally invasive treatment methods[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(5): 559-563.

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膝关节脱位的早期诊断及微创治疗方法

The early diagnosis of knee dislocation and its minimally invasive treatment methods

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