后交叉韧带损伤的诊断治疗

目的通过对收治的４８例后交叉韧带损伤患者的病历分析，探讨有关后交叉韧带损伤的诊断和治疗的问题。方法对所有患者，经物理检查、影像学检查，并结合病史确诊后，分别予以石膏托外固定、起止点重建、原位缝合修补、髂胫束移植重建，半腱肌移植重建、髌韧带中１／３的骨－韧带－骨移植重建、股薄肌移植重建，并配合康复治疗。结果所有病例有效随访４个月～２０年，平均６年８个月，方法不同，疗效不同，优良率５２．１％，有效率７９．２％。结论（１）提高早期的诊断率，可以提高后交叉韧带损伤的疗效。（２）非手术治疗的疗效，远低于手术治疗的疗效，而手术治疗的方法较多，其中以带骨块的起止点修复重建术和髌韧带中１／３的骨－韧带－骨自体移植重建疗效最佳。（３）早期手术治疗和及时、正确的修复并发的复合伤，是提高治疗效果，减少膝关节功能的丢失，降低和推迟晚期并发症发生的重要前提。

The Diagnosis and Treatment of Posterior Cruciate Ligament Injury

ObjectiveTo compare the treatment results of posterior cruciate ligament injury of the knee by different methods. MethodsFortyeight patients with posterior cruciate ligament injury treated by a variety of nonoperative and operative methods were reviewed. ResultsAll the patients were followedup for an average of 6 years and 8 months(range, 4 months to 20 years), and had a satisfactory rate of 52.1%. ConclusionThe satisfactory rate in nonoperative group was lower than that in operated ones. Among a variety of surgical methods, the bone-tendon-bone reconstruction appeared to be the best. Early operation and correctly repairing the associated injuries were crucial to improve the result and reduce the loss of function and late complications.