首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 62 毫秒
1.
汤睿  刘沛 《骨科》2020,11(2):125-130
目的探讨关节镜下Ethibond缝线复位固定治疗后交叉韧带(posterior cruciate ligament,PCL)胫骨止点撕脱骨折的临床效果。方法对2015年2月至2017年12月我院收治的22例PCL胫骨止点撕脱骨折病人,在关节镜下常规前内、前外侧入路结合双后内侧入路显露骨折,将PCL重建定位器置入并在其引导下由前内向后于撕脱骨折床3点和9点处钻出导针,制造两骨隧道。术中使用双根5号Ethibond缝线在韧带后方骨块近侧打结,经胫骨双骨隧道将缝线拉出于胫骨前侧,充分复位骨折块,缝线收紧打结固定。术后定期随访,了解骨折复位、愈合情况及活动度,采用KT 1000测量及后抽屉试验评估膝关节稳定性,比较手术前后的Lysholm评分、Tegner评分、国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分。结果随访时间为19~28个月,平均24.5个月。术后6周骨折均愈合,复位良好。术后6个月,所有病人后抽屉试验均为阴性,无伸膝、屈膝受限,平均屈膝活动度为138.5°±3.5°。手术前后的KT 1000测量值分别为(10.9±0.7)mm、(1.5±0.6)mm,Lysholm评分分别为(36.5±4.9)分、(94.2±3.3)分,Tegner评分分别为(2.6±0.8)分、(6.7±0.4)分;IKDC评分:术前C级7例(31.82%)、D级15例(68.18%),术后A级21例(95.45%)、B级1例(4.55%)。上述指标手术前后的数值比较,差异均有统计学意义(P均<0.05)。结论关节镜下经胫骨双骨隧道应用5号Ethibond缝线复位固定治疗PCL胫骨止点撕脱骨折,固定方法简便可靠,临床疗效满意。  相似文献   

2.
[目的]探讨关节镜下缝线空心钉固定治疗后交叉韧带胫骨止点撕脱性骨折的可行性及近期疗效.[方法]对10例后交叉韧带胫骨止点撕脱性骨折行关节镜下PCL胫骨止点缝合及空心钉固定术.术中使用2根5号Ethi-bond聚乙烯缝线,在韧带下方骨块上方从前往后拢住韧带,经韧带两侧胫骨骨隧道拉到胫骨内下方.在骨隧道下方2 cm处打入带垫圈的直径4.5mm空心钉.[结果]手术时间60~90 min,平均75 min.10例均随访12~18个月,平均15个月.术后6周,所有骨折均获愈合,未出现骨折移位.无胭窝部神经、血管损伤并发症.术后半年Lysholm膝关节功能评分83~95分(89.6±4.03)分.[结论]关节镜下通过双后内侧入路缝线空心钉固定治疗后交叉韧带胫骨止点撕脱性骨折,术中关节镜监控可靠,操作简便,效果可靠,值得推广.  相似文献   

3.
目的 探讨关节镜下缝线"8"字打结、空心钉固定治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的可行性及近期疗效.方法 对15例ACL胫骨止点撕脱性骨折行关节镜下ACL胫骨止点缝合及空心钉固定术,采用在关节镜下结合常规关节镜入路和经髌腱入路进行骨折复位固定,术中使用双根5号Ethibond聚乙烯缝线,在韧带下方、骨块上方经前内侧入路从后往前拢住韧带,并打结呈"8"字形,经韧带两侧胫骨骨隧道拉到胫骨内下方.在骨隧道下方2 cm处打入带垫圈的直径4.5 mm空心钉,做后抽屉试验,同时拉紧固定线,复位骨块,将固定线固定于空心钉垫圈下,拧紧空心钉.结果 手术时间40~60min,平均50 min.15例随访6~18个月,平均12个月.术后6周,所有骨折均获愈合,未出现移位.术后3 个月,1例有Ⅰ度前抽屉试验阳性,其余患者均为阴性.所有患者屈伸膝活动度正常.术后半年Lysholm膝关节功能评分90~96分.结论 关节镜下缝线"8"字打结空心钉固定治疗ACL胫骨止点撕脱性骨折,术中关节镜监控可靠,操作简便,效果满意,值得推广.  相似文献   

4.
目的探讨关节镜下缝线固定治疗后交叉韧带胫骨止点撕脱骨折的疗效。方法选择膝关节前外侧、高位前内侧、后内侧切口,从胫骨外向撕脱处钻一骨道,将2根5号缝线绕过骨块韧带交界处,打结,将缝线引至骨道外并拉紧,用带鞘螺钉将缝线固定于骨道壁。结果术后骨折块均得到复位。随访3个月~1年,骨折均骨性愈合。术后Lysholm膝关节功能评分(97.3±2.4)分。结论关节镜下缝线固定治疗后交叉韧带胫骨止点撕脱骨折,方法简便,创伤小。  相似文献   

5.
目的探讨关节镜下空心钉联合带齿垫片内固定治疗后交叉韧带胫骨止点撕脱骨折的手术技巧与临床疗效。方法回顾性分析自2017-03—2019-10采用关节镜下双后内侧入路空心钉联合带齿垫片内固定治疗的24例后交叉韧带胫骨止点撕脱骨折,术后采用Lysholm评分、IKDC评分评价膝关节功能。结果 24例术中未出现医源性神经、血管损伤。术后24 h疼痛VAS评分为1~5分,平均2.8分。24例均获得随访,随访时间平均13.2(6~20)个月。骨折愈合时间为7~14周,平均10周。术后6个月膝关节功能Lysholm评分为78~99分,平均91.7分;IKDC评分为79~100分,平均89.2分。结论关节镜下双后内侧入路空心钉联合带齿垫片内固定治疗后交叉韧带胫骨止点撕脱骨折具有创伤小、术后疼痛轻、固定可靠、骨折愈合快、术后患者可早期功能锻炼改善膝关节功能等优点,但是手术操作难度大、技术要求高。  相似文献   

6.
小切口微创治疗单纯后交叉韧带胫骨止点撕脱骨折   总被引:2,自引:0,他引:2  
目的探讨小切口微创治疗后交叉韧带胫骨止点撕脱骨折的手术方法及疗效。方法对32例后交叉韧带胫骨止点撕脱骨折,采用膝关节后内侧小切口入路治疗。结果术后骨折均一期愈合,1例有Ⅰ度后抽屉试验阳性,2例有10°~15°的屈膝受限,Lysholm膝关节功能评分(91.6±3.6)分。结论采用膝关节后内侧小切口入路治疗后交叉韧带胫骨止点撕脱骨折,避开了膝关节后方神经、血管,有安全,创伤小,术后功能恢复快等优点。  相似文献   

7.
目的观察膝关节后正中小切口切开复位空心钉内固定治疗后交叉韧带胫骨止点撕脱骨折的疗效。方法回顾性分析自2010-08—2017-12诊治的32例后交叉韧带胫骨止点撕脱骨折,取膝后正中入路,以腘横纹为标志,向远侧作一长3 cm左右纵形小切口,用手指分离腓肠肌内侧头与腘血管神经束之间的间隙,直达胫骨后侧皮质,显露后交叉韧带胫骨止点撕脱骨折块及骨床,复位骨折,根据骨折块大小选用1或2枚空心钉固定骨折块,尽量达到双皮质固定,必要时可使用垫片。结果 32例均获得随访,随访时间18~36个月,中位时间26个月。1例出现腓肠内侧皮神经刺激症状,随访期间恢复。骨折均顺利愈合,无骨折再移位及内固定物松动。末次随访时屈膝活动度120°~145°,平均127°。末次随访时Rasmussen评分:优14例,良17例,可1例。结论膝关节后正中小切口空心钉内固定治疗后交叉韧带胫骨止点撕脱骨折操作简单,手术入路位于组织间隙且显露并不困难,手术时间短,术中出血量少,空心钉固定可靠。  相似文献   

8.
目的:探讨关节镜辅助下经膝关节后内侧入路双向骨锚钉及可吸收螺钉内固定治疗后交叉韧带胫骨止点撕脱骨折的临床效果。方法:对33例后交叉韧带胫骨止点撕脱骨折,在关节镜常规前侧入路进镜探查关节腔,处理发现的合并伤,并行膝关节后方入路切开,骨折复位,并以锚钉及可吸收螺钉内固定。术后定期随访6~10个月,了解骨折对位及愈合、膝关节稳定性及活动度,Lysholm膝关节功能评分标准评估患肢功能恢复情况。结果:术后3个月,骨折均骨性愈合,无明显移位。术后6个月,仅有1例患者后抽屉试验呈弱阳性。均尢膝关节屈伸受限。Lysholm膝关节功能评分为(84.2±2.1)分。结论:关节镜辅助下经膝关节后侧切口锚钉联合可吸收螺钉内固定治疗后交叉韧带胫骨止点撕脱骨折操作简便、安全、内固定效果可靠。  相似文献   

9.
目的探讨后交叉韧带胫骨止点撕脱骨折的手术入路和固定方法。方法2007年6月至2009年6月对17例后交叉韧带胫骨止点撕脱骨折患者,采用膝关节后内侧入路切开复位,11例用1~2枚空心钛钉固定,6例用钢丝固定。结果17例患者术后随访12-24个月,平均16.4个月,骨折均骨性愈合,术后12个月膝关节功能评定按Hohl评分标准评定,优12例,良3例,可2例,优良率88.2%。结论膝关节的后内侧人路为骨折的直视复位和固定提供了良好的操作空间,结合空心钉或钢丝内固定是治疗后交叉韧带胫骨止点撕脱骨折的一种有效方法。  相似文献   

10.
目的探讨关节镜下后内侧入路中空螺钉固定治疗后交叉韧带胫骨止点撕脱性骨折的手术技巧及疗效。方法对15例后交叉韧带胫骨止点撕脱性骨折行关节镜下复位经后内侧入路,克氏针临时固定,经克氏针置入单枚带垫片直径4.5 mm中空钛质螺钉固定。结果手术时间40~82 min,平均55 min。随访6~24个月,平均15个月。术后6周,所有骨折均获愈合,未出现骨折移位。无窝部神经、血管损伤并发症。所有患者均无屈伸膝活动受限,仅1例患者后抽屉试验弱阳性。术后半年Lysholm膝关节功能评分89~96分,平均92.5分。结论关节镜下通过后内侧入路带垫片中空螺钉治疗后交叉韧带胫骨止点撕脱性骨折,操作方便、安全,效果可靠。  相似文献   

11.
12.
We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.  相似文献   

13.
14.
B R Bach  R F Warren 《Arthroscopy》1989,5(2):137-140
We report our observation on the "empty wall" and "vertical strut" signs of anterior cruciate ligament (ACL) insufficiency. ACL tears most commonly occur in the midsubstance; arthroscopic evaluation of patients with these tears often reveals minimal evidence of previous ACL tissue along the intercondylar wall, thus giving the appearance of an "empty wall." In proximal ACL tears, the long remnant of ACL tissue may adhere to adjacent PCL tissue. Arthroscopically, one may see this vertically oriented strut of tissue, which to the casual arthroscopist may mimic a normal-appearing ACL except for orientation and tension. In addition, the "empty wall" sign will be noted because the lateral intercondylar wall becomes easily visible following ACL injury. In two separate prospective studies of 84 such patients, the combined incidence of the empty wall sign was 82%, and the incidence of the vertical strut sign was 50%. These findings should be sought for meticulously at the time of arthroscopic evaluation. The vertical strut should not be misinterpreted as an aberrantly oriented ACL or partial ACL tear.  相似文献   

15.
16.
Goal-directed attention to sound identity (what) and sound location (where) has been associated with increased neural activity in ventral and dorsal brain regions, respectively. In order to ascertain when such segregation occurs, we measured event-related potentials during an n-back (n = 1, 2) working memory task for sound identity or location, where stimuli selected randomly from 3 semantic categories (human, animal, music) were presented at 3 possible virtual locations. Accuracy and reaction times were comparable in both "what" and "where" tasks, albeit worse for the 2-back than for the 1-back condition. The partial least squares analysis of scalp-recorded and source waveform data revealed domain-specific activity beginning at about 200-ms poststimulus onset, which was best expressed as changes in source activity near Heschl's gyrus, and in central medial, occipital medial, right frontal and right parietal cortex. The effect of working memory load emerged at about 400-ms poststimulus and was expressed maximally over frontocentral scalp region and in sources located in the right temporal, frontal and parietal cortices. The results show that for identical sounds, top-down effects on processing "what" and "where" information is observable at about 200 ms after sound onset and involves a widely distributed neural network.  相似文献   

17.
18.
Editor—It is a common misconception that turning off thevaporizer while leaving the fresh gas flow (FGF) on, during  相似文献   

19.
20.
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号