膝关节内侧副韧带急性损伤诊治方法的探讨

目的探讨膝关节内侧副韧带急性损伤的诊治方法. 方法 1998年8月～2003年8月,对收治的87例膝关节内侧副韧带急性损伤均进行膝关节功能及MRI检查.其中35例Ⅰ、Ⅱ度损伤者行保守治疗;52例Ⅲ度损伤者行关节镜探查术,修复内侧副韧带,其中有21例应用前半部的股薄肌肌腱加强. 结果 32例Ⅰ、Ⅱ度损伤患者获6～24个月随访,平均13个月,按Lysholm评分标准,优良率达93.7%;50例Ⅲ度损伤患者术后获随访7～72个月,平均16个月,优良率达90%. 结论 MRI是确诊内侧副韧带Ⅰ、Ⅱ度损伤的重要手段,膝伸直位外翻应力时的直向不稳定是确诊Ⅲ度损伤的主要方法.Ⅰ、Ⅱ度损伤以保守治疗效果好,Ⅲ度损伤宜选择手术治疗.

DIAGNOSIS AND TREATMENT OF ACUTE MEDIAL COLLATERAL LIGAMENT RUPTURES OF THE KNEE

OBJECTIVE: To study the diagnosis and treatment of the acute medial collateral ligament ruptures of the knee. METHODS: From August 1998 to August 2003, 87 cases of acute medial collateral ligament ruptures were examined with physical method and MR imaging. Out of them, 35 cases of I degree and II degree ruptures were treated with non-surgery and 52 cases of III degree ruptures were treated surgically. The torn medial collateral ligaments were mended, 21 of which were strengthened with the anterior partial gracilis muscle tendon after the arthroscopy. RESULTS: In 35 cases of I and II degree ruptures, 32 were followed up 13 months on average. According to Lysholm scoring system, the clinical results were classified as excellent or good in 93.7% of the cases. In 52 cases of III degree ruptures, 50 were followed up 16 months on average. The excellent or good result was 90%. CONCLUSION: For I and II degree ruptures, MR imaging is an important way to definitely diagnose medial collateral ligament ruptures. Abduction stress test of knee extension shows that the medial direct instability is a main way to definitely diagnose III degree ruptures. The results of conservative treatment of I degree and II degree ruptures are excellent. Surgical therapy are fit for the cases of III degree ruptures.