半月板损伤护理查房辩析.ppt

半月板咬碎取出 Lock: MM 10-30., LM 70. Only Grade III of IV signals correlate with a meniscal tear. Someone has found MRI to be less sensitive in diagnosing peripheral meniscus tears and not useful in evaluating the meniscus after repair because of the persistence of Grade III signals after proven meniscal healing. At 10-year follow-up we have seen a 79% survival of repaired menisci. This broke down to an 11% retear incidence in stable knees and a 42% retear incidence in unstable knees. Of the patients with successful repairs, 85% had normal weight-bearing radiographs, documenting the biomechanical function of successfully repaired menisci. Our philosophy in treating a meniscus lesion is to eliminate the symptoms stemming from the torn meniscus so that the athlete can return to sport. We also, however, look for the best long-term result with the lowest possible risk for degenerative arthritis. Radial tears, however, did not result in a restoration of normal mechanical function, and this was attributed to the development to a fibroblastic scar that caused spread of the repair site. Results of partial meniscectomy for degenerative tears are not as good as those for traumatic tears (50- 60% vs. 80-95%, respectively). Athletes are able to return to unsupported ambulation in 1 to 3 days, return to strenuous training in 7 to 14 days, and return to competition in 3 to 4 weeks. Exceptionallly fit and well-motivated patients have been able to return to competition in 2 weeks or less. 概 述 分型及临床表现 治疗 个案护理 定义 半月板是2个月牙形的纤维软骨，位于胫骨平台内侧和外侧的关节面。其横断面呈三角形，外厚内薄，上面稍呈凹形，以便与股骨髁相吻合，下面为平的，与胫骨平台相接。这样的结构恰好使股骨髁在胫骨平台上形成一较深的凹陷，从而使球形的股骨髁与胫骨平台的稳定性增加。 半月板的前后端分别附着在胫骨平台中间部非关节面的部位，在髁间棘前方和后方。这个部位又可称做半月板的前角和后角。 半月板中内部分无血液供应，其营养主要来自于滑液，只有与胫骨缘连接的边缘部位能从滑膜得到血液供应，因其血供差，破裂后愈合能力很差。 半月板的形态 分内、外侧两个半月板. 内侧半月板两端间距较大，呈“C”型，边缘与关节囊及内侧副韧带深层相连。 外侧半月板呈“O” 形，中后1/3处有腘肌腱将半月板和关节囊隔开，形成一个间隙，外侧半月板与外侧副韧带是分开的。 最美的半月板，哪侧的？ 半月板的功能 减震缓冲作用（软骨） 充填作用，稳定关节 滚珠的作用，使关节易于伸屈旋转 分布滑液和润滑关节 半月板的矛盾运动 在膝关节屈伸运动时，半月板固定于胫骨上，并随其一同在股骨上运动，伸直时向前移动，