膝关节创伤的微创处理

Minimally-invasive management of injuries of knee joint

关节镜技术最早应用于膝关节内创伤微创性诊断与治疗,提高了急性膝关节损伤时关节内软骨损伤的诊断率;可以正确评估半月板损伤的部位、类型和范围,合理选择损伤半月板缝合、部分切除等术式,最大限度保留了半月板;可以进行前、后交叉韧带损伤的修复与重建。关节镜技术结合微创内固定技术可以治疗胫骨平台、髌骨、股骨髁骨折,辅助完成逆行交锁钉治疗股骨远端骨折。经皮微创解剖钢板内固定(如LISS)治疗膝关节邻近股、胫骨干骺端骨折,均提供了临床疗效。

The arthroscopic technique was first used for minimally invasive treatment and diagnosis of injuries inside the knee joint. It can make the diagnosis of acute cartilage injury more accurate. Since it can also correctly detect the location, type and scope of the meniscus injury, surgeons can reasonably decided whether the injured meniscus should be sutured or partially resected so as to maintain as most part of meniscus as possible. It can also be applied to repair or reconstruct the anterior and posterior cruciate ligaments. The combination of arthroscopic technique and minimally invasive internal fixation has often been used to treat fractures of tibial plateau, patella, and femoral condyles, as well as to assist the treatment of fractures of distal femur with retrograde interlocking nails. The internal fixation by percutaneous minimally invasive anatomical plates, e.g. Liss Invasive Stabilization System(LISS), has proved to be effective in the clinical treatment of fractures near tibial and femoral metaphyses.