膝关节脱位合并前后交叉韧带断裂一次性韧带重建的体会

The reconstrution of ligments for the knee dislocation with disruption of the anterior and posterior ligament

目的 获得膝关节最大限度的功能恢复。方法 16例膝关节脱位皆合并有前后交叉韧带损伤 ,术前进行了体检 ,X线和MRI检查 ,术中证实诊断是正确的 ,前交叉韧带取材于股直肌腱—髌骨筋膜—膑腱 ,共 12例 ,取材髂胫束 4例 ;后交叉韧带取半腱肌腱共 16例。结果 随访时间 8～ 12个月 ;8例膝关节功能完全恢复正常水平 ,另 8例膝关节伸 180° ,稳定、无痛 ,屈曲 90°。无行走不稳、疼痛和关节退行性改变。结论 膝关节脱位合并前后交叉韧带断裂者 ,应尽早施行韧带重建 ,固定 4周早期床上功能锻炼是关节功能恢复的关键措施。

Objective to recover the function of the knee joint.Method 16 patients with dislocation of the knee with disruption of the anterior and posterior cruciate ligaments,which were evaluated through preoperative physical examination,radiographs and MRI scans.The disgnosis was tested correct through observation during operation.The femoral rectus tendon-patella fascia-patella tendons were used to reconstruct the anterior cruciate ligament for 12 cases and iliotibial band for 4 cases.The semitendious muscle tendous were used to reconstruct the posterior cruciate ligament for 16 cases.Results All cases were followed-up for 8-12 months.Functional recovery of the knee joint was excellent in 8 cases.The knee stability of the knee was 90°and extension was 180°.All cases can walk steadily without joint stiffness.pain and degenerative osteoarthritis.Conclusion The key in the treatment of the knee dislocation with disruption of the anterior and posterior ligament is early surgery, early functional traion.