急性前交叉韧带损伤的治疗体会.docVIP

精品论文 参考文献 急性前交叉韧带损伤的治疗体会 梁俊升 李业海 徐俊杰 刘和风 　　（安徽医科大学附属巢湖医院 238000） 　　【摘要】目的:探讨关节镜下自体半腱肌、半膜肌重建前交叉韧带,并分析影响治疗效果的因素。方法:采用关节镜下自体半腱肌、半膜肌重建ACL。手术23例,男19例,女4例,年龄16—51岁,平均34岁。所有患者均采取自体半腱肌、半膜肌。术后随访6个月-2年,平均随访14月。结果:术前抽屈试验21例为（+）;Lachman试验术前21例阳性,术后全部为阴性,膝前痛4例，术后2例患者出现膝关节屈曲功能受限。按照美国膝关节协会(the American knee society，AKS):优18例,良3例,中1例,差1例。优良率达91.3%。结论:术中准确定位,胫骨止点采取挤压螺钉及锚钉双重固定是重建的关键,关节镜下手术创伤小,恢复快,术后予以康复指导,是ACL重建的好方法。 　　【关键词】前交叉韧带损伤 关节镜 自体半腱肌 半膜肌 　　【中图分类号】R686 【文献标识码】A 【文章编号】2095-1752（2014）24-0097-02 　　【Abstract】objective Arthroscopic autogenous semitendinosus,semimembranosus muscle for reconstruction of the anterior cruciate ligament, and analyzes factors influencing the therapeutic effect。method The use of arthroscopic autogenous semitendinosus,semimembranosus muscle reconstruction ACL.Operation in 23 cases, male 19 cases, female 4 cases, age 16 to 51 years old,average 34 years old.All patient were treated with autologous semitendinosus,semimembranosus muscle. Follow up of 6 months -3 years after a mean follow-up of 14 months。result Preoperative drawer test of 21 cases for (+); Lachman test was positive in 21 cases preoperatively, postoperatively in all were negative, 4 cases of anterior knee pain after operation, 2 patients with knee flexion function limitation.According to the American knee society the criteria of knee joint function evaluation:excellent in 18 cases, good in 3 cases, in 1 cases, poor in 1 cases. The excellent and good rate was 91.3%.Conclusion Accurate positioning in the operation, tibial insertion extrusion screws and anchors take double fixation is the reconstruction of the key, arthroscopicoperation little trauma, quick recovery, postoperative rehabilitation guidance to, is a good way to ACL reconstruction. 　　前交叉韧带（anterior cruciate ligament，ACL）是膝关节重要的前向稳定结构，断裂后可以产生明显的膝关节不稳，严重影响膝关节功能，如果不及时治疗，关节出现反复扭伤，容易引起关节软骨、半月板等重要结构的损害，导致关节过早老化和骨关节病的发生。解剖和生物力学特点决定了前交叉韧带在人群分布、损伤机制及合并损伤等方面，显现出与其他膝关节损伤不同的疾病特征。文献报道，美国普通人