青少年急性创伤性膝关节血肿的关节镜下诊治

Arthroscopic Diagnosisand Treatmentin AcuteTraumatic Hemarthrosisof the Kneein Adolesent

目的 :研究青少年创伤性膝关节血肿的合理诊治措施。方法 :1997年 2月～ 1998年 8月在关节镜下诊治的 11例青少年创伤性膝关节血肿患者。本组年龄最小 11岁 ,最大 19岁 ,平均 15 .5岁。其中骨软骨骨折 8例 ,半月板损伤 2例 ,前交叉韧带 (ACL)部分断裂 1例。均在关节镜下分别行游离体取出 ,骨床修整或钻孔 ,半月板部分切除 ,关节清理。结果 :本组 11例均获得随诊 ,平均随诊 15个月 ,关节功能基本正常。结论 :青少年创伤性膝关节血肿反映关节内结构损伤 ,影像学检查等不易准确反映伤情 ,关节镜技术有诊治兼具的优势。镜下诊治是合理的 。

Objective :Tostudythereasonablewayofdiagnosisandtherapyofacutetraumatichemarthrosisofthekneein adolesent.Methods :BetweenFebruary 1997andOctober 1998,11patients(aged 11-19years)withacutetraumatic hemarthrosisunderwentthearthroscopicprocedureunderextraepiduralanesthesia .Results :In 11cases ,therewere 8casesof osteochondralfracture ,4casesofthelateralfemoralcondyle ,2casesofpatella ,2casesofthemedialfemoralcondyle ,2cases ofmeniscaltearand 1caseofisolatedACLtear ,whichwereallrepairedosteochondraldefectsandremovedintra articularloose bodies ,alsorepairedmeniscaltearwithouthavingtoperformanarthrotomy .15months(6 2 5months)follow upshowedexcel lentandgoodresults .Conclusions :Acutetraumatichemarthrosisindicatesasignificantkneeinjury .Becauseoftheunreliable natureofradiographicevaluation ,thearthroscopicdiagnosisandtreatmentshouldbearationalmethod .