膝内侧半月板“湾征”对内侧副韧带断裂的诊断意义

目的内侧副韧带损伤后,关节镜下可见内侧半月板上滑膜缘完全显示,类似海湾形状,称为"海湾全景征"(简称"湾征"),判断其作为诊断膝内侧副韧带断裂标志体征的可靠性及意义。方法 2007年3月-2011年3月,纳入59例MRI检查提示内侧副韧带断裂患者作为观察组,其中男38例,女21例;年龄16～39岁,平均23.2岁;单纯内侧副韧带断裂12例,合并外侧半月板损伤16例,前交叉韧带损伤27例,前、后交叉韧带损伤3例,髌骨脱位1例。68例MRI检查提示无内侧副韧带断裂患者作为对照组,其中男45例,女23例;年龄25～49岁,平均31.8岁;前交叉韧带损伤38例,前、后交叉韧带损伤4例,前交叉韧带合并外侧半月板损伤26例。两组治疗前后行关节镜探查比较"湾征"出现情况。结果观察组膝内侧副韧带修复重建前关节镜探查均见"湾征",明确内侧副韧带断裂;修复重建后"湾征"消失。对照组交叉韧带重建前后均未见"湾征"。结论 "湾征"可作为关节镜下膝内侧副韧带断裂的诊断指征,以及术中韧带修复重建成功与否的判断依据。

Diagnostic significance of "bay sign" of medial meniscus under arthroscope in medial collateral ligament rupture of knee

Objective When knee medial collateral ligament(MCL) rupture,the upper surface of medial meniscus is exposed totally,like the gulf panoramic,which is called "panoramic views of the bay sign" or the "bay sign".To investigate the reliability and significance of the "bay sign" in diagnosis of knee MCL rupture under arthroscope.Methods Between March 2007 and March 2011,127 patients with knees injuries were divided into the observation group(n=59) and control group(n=68) based on the MRI results.In the observation group,59 patients had MCL rupture by MRI,including 12 cases of MCL injury alone,16 cases of MCL injury with lateral meniscus torn,27 cases of MCL injury with anterior cruciate ligament(ACL) injury,3 cases of MCL injury with ACL and posterior cruciate ligament(PCL) injury,and 1 case of MCL injury with patellar dislocation;there were 38 males and 21 females with an average age of 23.2 years(range,16-39 years).In the control group,68 patients had no MCL rupture by MRI,including 38 cases of ACL injury,4 cases of ACL and PCL injury,and 26 cases of ACL and lateral meniscus injury;there were 45 males and 23 females with an average age of 31.8 years(range,25-49 years).The "bay sign" was observed under arthroscope in 2 groups before and after operation.Results The positive "bay sign" was seen under arthroscope in the patients of the observation group before MCL repair;the "bay sign" disappeared after repair.No "bay sign" was seen in patients of the control group before and after ACL reconstruction.Conclusion The "bay sign" is a reliable diagnostic evidence of MCL injury.It can be used as a basis to judge the success of MCL reconstruction during operation.