创伤性膝关节脱位伴多发韧带损伤的早期手术修复重建

目的探讨创伤性急性腋关节脱位伴多发韧带损伤早期手术修复、重建的疗效。方法2006年10月_2012年12月经早期手术治疗的28例急性膝关节脱位伴多发韧带损伤的患者。所有病例均于早期行关节镜下前、后交叉韧带重建以及侧副韧带修补。重建材料选择异体肌腱，侧副韧带修补采用切开缝合或带线锚钉修复。伴随的其他组织损伤，如半月板、骨软骨损伤等均同期处理。根据Lysholm膝关节评分表对患膝功能进行评估。结果本组28例患者均获随访，平均随访时间为（28．4±2．4）个月。受伤至手术时间7～14（9．3±0.6d。末次随访所有患者伸膝无明显受限，膝关节屈曲（110±20）。，膝关节功能Lysholm评分为（84．0±8．0）分，与术前（40．1±5．2）分比较差异有统计学意义（P〈0．05）。结论创伤性膝关节多发韧带损伤可早期在关节镜下行前、后交叉韧带联合重建，同期行关节内外韧带结构修复增强，治疗效果满意。

Early surgical reparation and reconstruction of traumatic dislocated knee joint with multiple ligament injuries

Objective To investigate surgical outcomes of traumatic dislocated knee with multiple ligament injuries. Methods A retrospective study was done on 28 patients with traumatic knee dislocation from Oct. 2006 to Dec. 2012. They were treated with anterior cruciate ligament （ACL） and posterior cruciate ligament （PCL） reconstruction with tendon allograft under arthroscopy and the collateral ligaments and other structures of the knee were repaired. Knee joint function and stability before and after operation were evaluated according to the Lysholm scoring. Results All the patients were followed up for average 28.4 ± 2.4 months. The mean waiting time for operation was 9.3 ±0.6 （7 - 14） days. The latest follow-up showed that the joint range of motion was 110° ± 20°, and that the Lysholm score was 84.0 ± 8.0 points, significantly higher than that （40.1 ± 5.2） of pre-operation （ P 〈 0.05 ）. Conclusion With the advantages of minimally invasion and satisfactory knee joint function and stability, ligament reconstruction under arthroscopy is an ideal treatment method to traumatic dislocation of knee with multiple ligaments injuries.