外伤性膝关节后外侧旋转脱位的治疗

Treatment of Traumatic Posterolateral Rotatory Knee Joint Dislocation

【目的】探讨外伤性膝关节后外侧旋转脱位的治疗策略及其疗效。【方法】回顾性分析2006年6月至2010年10月6例外伤性膝关节后外侧旋转脱位患者的临床资料。6例患者先行手法复位，3周后关节镜检和修复内侧副韧带（MCL），Ⅱ期自体胭绳肌腱重建前交叉韧带（ACL）。【结果】伤口均甲级愈合，未发生骨筋膜室综合征及皮肤坏死，6例患者均获得随访，时间10～62个月，根据Lysholm膝关节功能评分标准评定：本组获优2例，良2例，可2例，优良率66．7％。【结论】外伤性膝关节后外侧旋转脱位需尽旱复位，开放手术修复MCL，Ⅱ期关节镜下重建AcL的方法能有效地恢复关节功能。

[Objective]To explore the treatment strategy of traumatic posterolateral rotatory knee joint dis- location and observe the efficacy. [Methods]Clinical data of 6 patients with traumatic posterolateral rotatory knee joint dislocation from June 2006 to Oct. 2010 were analyzed. All patients underwent manual reduction firstly, arthroscopy and the repair of medial collateral ligament（MCL） after 3 weeks, and stage II reconstruction of anterior cruciate ligarnent（ACL） by autologous hamstring tendon. [Results]All wounds were first intention after operations. No skin necrosis and compartment syndrome occurred. All cases were followed up for 10-62 months. According to Lysholm evaluation system, 2 patients got excellent results, and 2 patients were good, and 2 patients were fair. The excellent and good rate was 66.7%. [Conclusion] Traumatic posterolater al rotatory knee joint dislocation need the reduction as soon as possible. The repair of MCL by open surgery and stage II reconstruction of ACL by arthroscopic surgery can effectively recover the joint function.