Segond骨折及其合并症对膝关节稳定性的影响

目的探讨Segond骨折及其合并症的受伤机制、影响及其治疗。方法回顾性分析19例Segond骨折,19例(100%)均合并前交叉韧带损伤,其中前交叉韧带体部撕裂13例(68.4%),胫骨髁间棘撕脱骨折6例(31.6%);同时合并后交叉韧带损伤1例(5.3%);合并内侧副韧带损伤8例(42.1%);合并外侧结构损伤(包括外侧副韧带损伤及腓骨头损伤)5例(26.3%);合并半月板损伤11例(53.3%);合并胫骨平台或股骨髁骨折4例(21.1%)。19例患者均行手术治疗。其中韧带重建13例,骨折复位固定6例。结果入院时膝关节功能Lysholm评分为(33.73±4.56)分,国际膝关节文献委员会(IKDC)评分为(41.27±4.63)分。术前膝关节平均主动活动度(95.37±6.54)°。19例均获随访,随访时间12~18个月。术后膝关节活动度均恢复满意,为(127.31±5.53)°,与术前比较差异有统计学意义(P<0.05)。Lysholm评分明显提高,达(93.67±3.89)分,与术前比较差异有统计学意义(P<0.05)。IKDC评分也明显提高,达(89.04±2.87)分,与术前比较差异有统计学意义(P<0.05)。结论 Segond骨折对及时发现膝关节内的合并损伤的指示性作用不可忽略,并且更应该重视前外侧结构的稳定性,其为前交叉韧带提供了一定的保护作用,更加深入的研究Segond骨折的受伤机制,可以对膝关节前外侧不稳定提供更加重要的信息及帮助,能为膝关节结构的重建提供更有价值的帮助。

Effect of Segond Fracture and Its Complications on the Stability of the Knee Joint

Objective To investigate the mechanism,effect and treatment of Segond fracture and its complications.Methods Retrospective analysis of 19 cases of Segond fracture,19 cases(100%) were combined with anterior cruciate ligament injury,Including13 cases(68. 4%) of anterior cruciate ligament rupture,6 cases(31. 6%) of tibial eminence avulsion fractureof ACL; Furthermore,1 case(5. 3%) was combined with posterior cruciate ligament injury; 8 cases(42. 1%) was combined with medial collateral ligament injury; 5 cases(26. 3%) was combined with Lateralcollateral ligament or capitulum fibulae injury; 11 cases(53. 3%) was combined with meniscus injury; 4 cases(21. 1%) was combined withtibial plateau or femoral condyle fracture. 19 patients underwent surgical treatment. Among them,13 cases of ligament reconstruction,fracture reduction and fixation in 6 cases. Results On admission,the Lysholm score of knee joint function was(33. 73± 4. 56) and the International Knee Documentation Committee(IKDC) score was(41. 27±4. 63). Preoperative of the averageactivity ROM of kneejoint(95. 37±6. 54) °. 19 cases were followed up for12 to 18 months. The postoperative knee joint activity degree was satisfactory,and the difference was statistically significant(P <0. 05) for(127. 31±5. 53) °. The postoperative Lysholm score(93. 67±3. 89) was significantly improved,and the difference was statistically significant(P<0. 05). The postoperative IKDC score(89. 04±2. 87) was significantly improved,as compared with the preoperative(P<0. 05).Conclusion Segond fracture for the timely detection of knee joint injuries indicative role can not be ignored,and should attach importance to the stability of anterolateral structure. It provides a protective effect for the anterior cruciate ligament,and further studies the mechanism of the injury of Segond fracture,and can provide more important information and help to the anterior lateral instability of the knee joint,and can provide more valuable help for the reconstruction of the knee joint structure.