膝关节脱位合并动脉损伤10 例报告 - 中国骨与关节杂志.pdf

中国骨与关节杂志 2016 年 6 月第 5 卷第 6 期 Chinese Journal of Bone and Joint, June 2016, Vol 5, No.6 . 469 . . 论著 Original article . 膝关节脱位合并 动脉损伤 10 例报告 程可可　潘振宇　喻爱喜　陶圣祥　卜祥鹏　张浩 DOI: 10.3969/j.issn.2095-252X.2016.06.014　　中图分类号：R684.7 作者单位：430071　武汉大学中南医院显微骨科，武汉大学医学院显微外科研究所 通信作者：潘振宇，Email: soloistp@126.com 【摘要】　目的　观察膝关节脱位合并 动脉损伤诊治后的疗效。方法　10 例中，闭合性损伤 6 例，开 放性损伤 4 例，伤后 10 h 转运至我院，及时予以膝关节复位外固定器固定、修复断裂血管、小腿切开减压以 及神经缝合、韧带重建等处理。结果　患肢均得以保存。随访 3 个月至 6 年。2 例在术后 2 年内重建交叉韧 带，膝踝关节活动良好。4 例合并腓总神经损伤者 2 例后期行踝关节融合术。1 例小腿骨筋膜室综合征患者肌 肉坏死后踝关节功能障碍，术后 9 个月行踝关节融合术。1 例术后即重返工作。3 例术后 2 年仍有关节疼痛和 关节僵硬症状。1 例术后 3 年失访。结论　早期诊断，及时恢复血液供应，尽早重建膝关节交叉韧带，可以有 效提高膝关节脱位合并 动脉损伤的疗效。 【关键词】　膝关节；膝脱位； 动脉；创伤和损伤 Diagnosis and treatment of dislocation of the knee joint with popliteal artery injury CHENG Ke-ke, PAN Zhen- yu, YU Ai-xi, TAO Sheng-xiang, PU Xiang-peng, ZHANG Hao. Department of Micro-orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, PRC Corresponding author: PAN Zhen-yu, Email: soloistp@126.com Abstract Objective To study the curative effect / after the diagnosis and treatment of dislocation of the knee 【 】 joint with popliteal artery injury. Methods In 10 patients, 6 cases had closed injury, 4 cases had open injury; 10 h after injury the patients were transported to our hospital. Timely reduction and external fixator fixation of knee joint, leg osteo-fascial compartment decompression, repair of broken blood vessels and nerve, ligament reconstruction treatment were performed. Results Limbs have been saved, in 1 case the wound healed after repeated debridement. In another case the wound healed after skin grafting of popliteal fossa posterior, the patient was followed up for 3 months to