训练引起膝关节半月板损伤的诊断和治疗

目的：分析战士训练方式与膝关节半月板损伤的联系，探讨膝关节半月板损伤的诊断和治疗。方法：训练引起膝关节半月板损伤的患者71例，72个膝关节，79个半月板。其中男68例，女3例，年龄为17—35岁，平均年龄25．2岁。跑步训练伤32例，越野急行军训练伤11例，越障训练伤28例.术前患膝均行MRI检查，发现均为半月板撕裂伤。71例患者均行关节镜下半月板部分或次全切除术。结果：术中关节镜检查发现，71例72个膝关节内均有不同程度半月板损伤，同时还发现8例盘状半月板，术前MRI检查5例未发现盘状半月板。6例伴有前交叉韧带部分损伤，术前MRI检查发现2例，4例未发现。左膝关节内外侧半月板损伤各17个；右膝关节内侧半月板损伤21个，外侧半月板损伤24个，其中1例双膝关节均为外侧半月板损伤。术后第3d，患者均能下地不扶拐行走，1个月后基本恢复正常生活。其中1例患者伴有前交叉韧带大部分损伤（2／3）的患肢行走不稳，半年后再行关节镜下前交叉韧带重建术，术后3个月基本恢复正常行走。结论：战士训练引起膝关节半月板损伤的主要受伤方式是：跑步训练、越障训练和越野急行军训练。MRI检查基本可以明确诊断。关节镜下行半月板部分或次全微创切除术，损伤小，恢复快，大部分患者术后1个月可继续参加部队正常训练。

Diagnosis and treating strategy of knee meniscus injuries resulting from soldiery

Objective:To explore the relation between the soldiery programs and knee meniscus injuries,and to investigate the diagnosis and treating strategy of these injuries.Methods:Seventy-two knees and 79 meniscus of 71solder patients with soldiery injury of meniscus were included in this study.The group consisted of 68 males and 3 females,at the age of 17-35 y(25.2 on average).Thirty-two injuries were caused by running,11 injuries by crosscountry march and 28 injuries by obstacle race.Involved knee underwent MRI(Magnetic Resonance Imaging)scan before operation,which reported meniscus injury at various degrees.Partial or subtotal ectomy of meniscus were carried out under the knee arthroscope.Results:Arthroscopic exploration demonstrated meniscus injuries at various degrees in 72 knees of 71 cases,as well as 8 discord meniscus which were neglected in MRI results before operation.Six knees were demonstrated partial injuries of anterior cruciate ligments,two out of which were suggested in MRI scan and the other 4 were neglected.There were 17 medial and lateral meniscus injuries respectively in the left knee,21 medial and 24 lateral meniscus injuries in the right one.One case of bilateral knee injuries which were both at the lateral meniscus was included in the group.The patient would walk without support at the third day postoperatively and restart a normal life in a month generally.One case,combined by an injury involving major part of the anterior cruciate ligment(2/3),complained unstability of the knee injured.The patient underwent a syndesmoplasty of the anterior cruciate ligment under the arthroscope half a year after the operation,and walked stably in 3 months.Conclusion:Soldiery programs that induced meniscus injuries including running,crosscountry march and obstacle race.Diagnosis could be confirmed by MRI scan.Partial or subtotal ectomy of meniscus under arthroscope was favor for(the minimal) invasion and short period of recovery.Patients could restart training in a month after the(operation.)