手术治疗膝关节脱位9例

Operative Management of 9 Cases of Knee Dislocation

目的：探讨治疗膝关节脱位的外科治疗方法并评定其临床结果。方法：9例膝关节脱位患者尽可能解剖修复或用自体或（和）异体韧带重建的方法治疗，随访12个月以上，评价其主、客观效果。结果：患者的平均lysholm积分84．4分，总体1KDC率接近正常者5例，异常3例，严重异常1例。术后膝关节屈膝达到平均126°2例明显屈膝受限的患者同时伴有伸膝受限3～5°。结论：手术解剖修复和／或重建韧带的方式治疗膝关节脱位。经过12个月随访获得了满意的主、客观效果。多数患者可恢复到日常活动而仅有较少症状。膝关节脱位的预后与膝关节损伤的程度密切相关；手术时机也可能极为重要。

Objective： To evaluate the surgical treatment method of knee dislocation and to evaluate the clinical results. Methods：9 patients presented with knee dislocation underwent surgical treatment within 10 days after injury. Anatomical repair and（or）replacement was performed with allograft（autograft）tissue. All patients followed--up for subjective and objective evaluation with use of I.ysholm and IKDC knee rating scales at a minimum of 12 months after the operation. Result： The mean Lysholm score was 84.4 points. The final overall IKDC rating was nearly normal for 5 knees,abnormal for 3,and severely abnormal for 1.The total are of motion was mean 126°（range 80°-150°）,2 cases with a flexion constraint bad loss of extension of 3-5°.Conclusion：Surgical treatment of anatomical repair and/or replacement in our pntients of the knee dislocation achieved satisfactory subjective and objective outcomes after postoperative 12 months.Most patients were able to perform daily activities with few problems.The prognosis of knee dislocations was related closely with degree of knee injury.The operation timing is probably key influencing factor.