本文選題：前交叉韌帶損傷 + 軸移試驗(yàn)　； 參考：《中國運(yùn)動(dòng)醫(yī)學(xué)雜志》2017年02期

【摘要】：目的:對(duì)合并高度軸移不穩(wěn)定的前交叉韌帶損傷患者,在前交叉韌帶重建的手術(shù)過程中,施行前外側(cè)肌腱固定,分析該方法對(duì)恢復(fù)膝關(guān)節(jié)穩(wěn)定性的作用與臨床效果。方法:2015年6月至2015年12月,共140例患者診斷為前交叉韌帶損傷,于我科接受手術(shù)治療。其中,18例患者在麻醉下檢查軸移試驗(yàn)表現(xiàn)為2+至3+,入選本研究。在手術(shù)過程中,在重建前交叉韌帶的基礎(chǔ)上,取髂脛束后方纖維做前外側(cè)肌腱固定。患者在術(shù)后即刻、6個(gè)月和12個(gè)月時(shí)接受臨床隨訪,采用KT-1000檢查膝關(guān)節(jié)前后向穩(wěn)定性,采用軸移試驗(yàn)評(píng)估膝關(guān)節(jié)旋轉(zhuǎn)穩(wěn)定性。使用Lysholm主觀功能評(píng)分評(píng)估膝關(guān)節(jié)功能。結(jié)果:18例患者平均獲得12.7±2.4個(gè)月隨訪,男性14例,女性4例,平均年齡28.3±7.1歲。至最終隨訪時(shí),全部患者無膝關(guān)節(jié)不穩(wěn)定主訴。前后向穩(wěn)定性KT-1000檢查患側(cè)-健側(cè)差值平均為2.3±0.7 mm,與術(shù)前(9.2±2.6mm)相比有顯著差異(P0.01)。術(shù)前麻醉下檢查,13例患者軸移試驗(yàn)2+,5例患者3+。術(shù)后即刻檢查軸移試驗(yàn)均為陰性。最終隨訪時(shí),17例患者軸移試驗(yàn)陰性,1例患者1+,術(shù)后與術(shù)前相比有顯著差異(P0.01)�；颊週ysholm評(píng)分術(shù)前平均為67.7±5.9(55至78),術(shù)后為89.0±4.6(75至95),術(shù)后相比術(shù)前有顯著改善(P0.001)。結(jié)論:對(duì)前交叉韌帶損傷合并高度軸移試驗(yàn)陽性的患者,在重建前交叉韌帶的同時(shí),采用前外側(cè)肌腱固定的方法,可有效改善軸移試驗(yàn)的結(jié)果,恢復(fù)關(guān)節(jié)穩(wěn)定性,術(shù)后早期隨訪結(jié)果滿意。
[Abstract]:Objective: to analyze the effect and clinical effect of anterior cruciate ligament (ACL) reconstruction with anterior cruciate ligament (ACL) reconstruction in patients with anterior cruciate ligament (ACL) injury. Methods: from June 2015 to December 2015, 140 patients were diagnosed with anterior cruciate ligament injury and operated in our department. The axial shift test was performed in 18 patients under anesthesia, and was included in this study. During the operation, the anterior cruciate ligament was reconstructed and the anterior lateral tendon was fixed with the posterior fiber of iliotibial tract. The patients were followed up immediately, 6 months and 12 months after operation. The anterior and posterior stability of knee joint was examined by KT-1000, and the rotation stability of knee joint was evaluated by axial shift test. Lysholm subjective function score was used to evaluate knee function. Results 18 patients were followed up for an average of 12.7 鹵2.4 months, 14 males and 4 females, with an average age of 28.3 鹵7.1 years. By the end of follow-up, all patients had no major complaints of knee instability. The average difference between the diseased side and the healthy side was 2.3 鹵0.7 mm in anteroposterior stability KT-1000, which was significantly different from that before operation (9.2 鹵2.6 mm). Preoperative anesthesia examination of 13 patients with axial shift test 2 and 5 patients with 3. The axial shift test was negative immediately after operation. At the end of follow-up, there were 17 cases with negative axial shift test (1 case) and 1 case with negative axial shift test (1 case). There was a significant difference between preoperative and postoperative patients (P 0.01). The average Lysholm score before operation was 67.7 鹵5.9 to 78, and after operation was 89.0 鹵4.675 to 95, which was significantly improved compared with that before operation (P 0.001). Conclusion: in the patients with anterior cruciate ligament injury and high axial shift test, anterior cruciate ligament reconstruction and anterior lateral tendon fixation can effectively improve the results of axial transfer test and restore joint stability. Early follow-up results were satisfactory.
【作者單位】： 北京積水潭醫(yī)院運(yùn)動(dòng)醫(yī)學(xué)科;
【分類號(hào)】：R687.4

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