摘要
[目的]探讨膝关节脱位多发韧带损伤患者早期评估及个性化处理的近期疗效。[方法]回顾性分析2015年3月—2017年12月诊治的24例膝关节脱位多发韧带损伤患者的临床效果。术前评估膝关节韧带、血管损伤情况,2例腘动脉损伤者急诊手术修复血管。3例不可复性脱位患者急诊行膝关节脱位切开复位后交叉韧带重建+内侧副韧带修补手术治疗。韧带重建术于伤后10~14 d进行,分别重建PCL、PLC和ACL。[结果]所有患者均顺利完成手术,术中均无血管、神经损伤等并发症。所有患者随访12个月以上,与术前相比,末次随访时24例患者的抽屉试验、胫骨前后移动距离、拔号试验旋转角度均显著减少(P<0.05),而Lysholm评分显著增加(P<0.05),IKDC评级显著改善(P<0.05)。[结论]膝关节脱位多发韧带损伤患者重视早期评估并制定相应治疗方案,其近期疗效满意。
[Objective] To explore the short-term clinical outcomes of early evaluation and individualized treatment of knee dislocation and knee multiple ligament injuries. [Methods] A retrospective study was conducted on the clinical results of 24 patients who received individualized treatment based on complete evaluation for knee dislocation and knee multiple ligament injuries from March 2015 to December2017. The knee ligament states and blood vessel damage were evaluated before operation. Of them, 2 patients who had popliteal artery damaged were treated in emergency surgery to repair blood vessels, 3 patients with irreversible dislocation underwent open reduction of knee dislocation and cruciate ligament reconstructions combined with medial collateral ligament repair as soon as possible, whereas most patients had ligament reconstruction performed 10 to 14 days after injury, involving PCL, PLC, and ACL reconstructions respectively. [Results] All patients were operated on smoothly with no complications, such as vascular and nerve injury during the operation. All patients were followed up for more than 12 months. Compared with those preoperatively, tibia anteroposterior displacement in drawer test and rotation angle in dial test reduced significantly(P<0.05), while the Lysholm score increased significantly(P<0.05), and the IKDC grade improved significantly(P<0.05), in all the patients at the latest follow-up. [Conclusion] Knee dislocation accompanied with knee multiple ligament injuries should be paid attention to the early assessment to formulate individualized treatment plans, which lead to satisfactory shortterm outcomes.
作者
仲鹤鹤
金瑛
吴术红
刘毅
ZHONG He-he;JIN Ying;WU Shu-hong;LIU Yi(Department of Joint Surgery,Affiliated Hospital,Zunyi Medical University,Zunyi 563000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第12期1132-1135,共4页
Orthopedic Journal of China
基金
四川大学华西医院“135”工程项目(编号:ZY2017301)。
关键词
膝关节脱位
多发韧带损伤
早期评估
个性化治疗
knee dislocation
knee multiple ligament injuries
early evaluation
individualized treatment
