异常加深的股骨外侧髁压迹是前交叉韧带撕裂的间接证据

目的:探讨股骨外侧髁压迹异常程度与前交叉韧带损伤之间的关系.方法:回顾研究2013年1月至2013年11月治疗的前交叉韧带损伤16例患者的X线片和MRI影像学资料,其中男14例,女2例;左膝关节5例,右膝关节11例;年龄19～52岁,平均28.3岁.膝关节侧位X线或MRI矢状位提示股骨外侧髁压迹有异常,使用影像PACS系统中测量工具测量压迹的深度,并分析患者病历资料、体格检查及关节镜术中影像学资料.结果:4例侧位X线片和MRI矢状位可见股骨外侧髁压迹异常并深度2.0 mm,MRI示前交叉韧带撕裂,前抽屉试验和拉姆征均阳性,关节镜探查手术证实前交叉韧带完全撕裂;2例侧位X线片股骨外侧髁压迹未见异常,但MRI矢状位示股骨外侧髁压迹异常并深度1.0 mm,MRI示前交叉韧带撕裂,前抽屉试验和拉姆征均阳性,MRI示前交叉韧带撕裂,其中1例关节镜探查手术证实前交叉韧带完全撕裂,另1例因未行手术探查而无法证实是否完全断裂.结论:膝关节侧位X线片上股骨外侧髁压迹异常加深与前交叉韧带撕裂有密切相关,异常加深的股骨外侧髁压迹是前交叉韧带撕裂的间接证据.

An abnormal deeper lateral femoral notch is an indirect evidence for anterior cruciate ligament tear

Objective:To investigate the relationship between degree of abnormal deeper lateral femoral notch between anterior cruciate ligament tear. Methods:The radiograph and MRI image material of 16 patients with anterior cruciate ligament injury from January 2013 to November 2013 were reviewed including 14 males and 2 females with an average age of 28.3 years old ranging from 18 to 52 years. Eleven cases was on right side and 5 on left. Survey tool of PASC imaging system was used to measure the depth of lateral femoral notch in patients with abnormal indicated by lateral X-ray view or sagittal view of MRI in knee joint,while clinical data,physical examination,image material in arthroscopy of these patients were retrospective researched. Results:Four patients had an abnormal lateral femoral notch with the depth of 2 mm on lateral X-ray and sagittal MRI,while positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI,and completed tears were comfirmed on the operation of arthroscopy. Two patients without abnomal lateral femoral notch on lateral view of X-ray while with the depth of 1 mm on sagittal view of MRI were also coupled with positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI,and one of them were comfirmed completed anterior cruciate ligament tears on the arthroscopy operation and completed tear could not comfirmed on another one because of disagreed with arthroscopy operation. Conclusion:There appears to be an association between abnormal lateral femoral notch on lateral view of knee with anterior cruciate ligament tears. An abnormal deeper lateral femoral notch is an indirect evidence for anterior cruciate ligament tears.