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
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。
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.
Knee / Dislocation / Arthroscopy； Cruciate ligament / Repair and reconstruction
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