锚钉治疗膝内侧副韧带股骨髁止点损伤的生物力学及临床研究-外科学(骨科)专业毕业论文.docxVIP

温卅I医学院硕士学位论文第一部分锚钉治疗膝内侧副韧带股骨髁止点 温卅I医学院硕士学位论文 第一部分锚钉治疗膝内侧副韧带股骨髁止点 Ⅲ度损伤临床研究 中文摘要 目的：探讨应用带线锚钉治疗膝内侧副韧带股骨髁止点III度损伤的手术方 法及治疗效果。 方法：自2009年3月至2011年9月对27例膝内侧副韧带股骨止点III度患 者用带线锚钉行止点重建修复手术。其中男19例，女8例；年龄19．60岁，平 均36．5岁；左膝关节16例，右膝关节11例：交通事故17例，运动伤6例，其 他伤4例。受伤至手术时间4-10 d，平均7．2d。单纯膝内侧副韧带股骨止点损 伤有12例，合并半月板和(或)前交叉韧带损伤有15例。所有患者先行膝关节镜 探查，关节内合并伤先行处理。再行膝内侧副韧带切开修复。切口自内收肌结节 上2 cm开始向下经内收肌结节，并根据术中需要沿胫骨前内侧向远端延伸。注 意保护隐神经，逐层切开，寻找内侧副韧带断端及股骨髁部附丽点，清理软组织 及血肿，将韧带附着骨面小心“鱼鳞状”打磨粗糙，并有少许新鲜渗血，并用 TWINFIX TI 5．0mm带线锚钉锚钉垂直附丽点骨面旋入，锚钉植入皮质骨2-3mm (或参照手柄第一个刻度线为旋入深度)，保持膝关节轻度内翻位，用钉尾的不 吸收缝线编织韧带断端并收紧(“8”字缝合或改良Kessler缝合)缝合。术后佩戴膝 关节功能支具，早期功能锻炼，并随访，术前术后参照((Lysholm膝关节运动伤 病评分表》评分。 结果：随访时间为6～18个月， 平均10．5个月，创口均I期愈合，无感 染等并发症。病人Lysholm膝关节运动伤病评分从术前的33．8+3．6分提高到术后 的87．6+8．1分，经统计学处理，结果显示有显著性差异pO．01)。 结论：带线锚钉治疗膝内侧副韧带股骨髁止点III度损伤，较传统修复方法创 伤小、操作方便、固定牢固，便于早起功能锻炼，近期疗效满意。远期疗效及并 发症还需进一步观察。 关键词内侧副韧带；膝损伤；锚钉；治疗方法；临床研究 ．4． 温州医学院硕士学位论文 温州医学院硕士学位论文 Part I Clinical Research of HI Degree Medial Collateral Ligament Inj ury at Femoral Condyle with Suture Anchor Abstract objective：To research the clinical effect and methd of surgical treatment for III degree medial collateral ligament injuries at femoral condyle． Method：Twenty．seven patients cases ofⅢdegree knee medial collateral ligament at femoral condyle were repaired with anchors from March 2009 to September 20 1 1． There were 1 9 males and 8 females；111eir ages were 1 9．60 years．averaged 36．5 years． Left kneewere 1 6 cases．11 cases were the right．T11e patients of straffic accidents were 1 7 cases，sports injuries were 6 cases，4 cases were other injuries．The time between injury and surgery Was 1 0 days，all average of 7．2d．111e knee medial collateral ligament femoral attachment damaged only were 1 2 cases．1 5 cases of combined meniscus and(or)anterior cruciate ligament injury．First，All patients were explored by arthroscopic knee ioints and immediately dealed with the patients with intra．articular injuries．111en the knee medial collateral ligament was repaired．The incision was on the beginning o