[1]吴术红,刘毅,熊华章.部分腓骨长肌腱重建膝关节后外侧复合体的临床分析[J].第三军医大学学报,2016,38(12):1452-1456.
 Wu Shuhong,Liu Yi,Xiong Huazhang.Functional reconstruction of posterolateral complex by part of peroneus longus tendon[J].J Third Mil Med Univ,2016,38(12):1452-1456.
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部分腓骨长肌腱重建膝关节后外侧复合体的临床分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第12期
页码:
1452-1456
栏目:
临床医学
出版日期:
2016-06-30

文章信息/Info

Title:
Functional reconstruction of posterolateral complex by part of peroneus longus tendon
作者:
吴术红刘毅熊华章
遵义医学院附属医院关节外科
Author(s):
Wu Shuhong Liu Yi Xiong Huazhang

Department of Joint Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou Province, 563003, China

关键词:
膝关节后外侧复合体后外侧旋转不稳定关节镜
Keywords:
knee joint posterolateral complex posterolateral rotation instability arthroscopy
分类号:
R322.72; R684; R687.2
文献标志码:
A
摘要:

目的      探讨部分腓骨长肌腱重建膝关节后外侧复合体(posterolateral complex,PLC)的手术方法及临床疗效。      方法      2012年7月至2014年7月,本科采用部分腓骨长肌腱模拟重建PLC的三大核心韧带治疗Fanelli B型或C型韧带实质部断裂的后外侧旋转不稳定患者24例,均为多发韧带损伤,随访时间大于1年,比较手术前后伸膝0°位、屈膝30°位膝关节内翻、外旋试验(Dial-test)及国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分情况。      结果      患者均获随访。所有患者伸膝无受限,轻度屈膝受限。内翻情况:术前伸膝0°位Ⅱ度11例,Ⅲ度13例。屈膝30°位Ⅱ度 9例,Ⅲ度15例;术后伸膝0°位Ⅰ度2例,屈膝30°位Ⅰ度5例,其余阴性。Dial-test:术前胫骨外旋增加角度均大于10°,其中C级21例,D级3例;术后均小于10°,其中A级19例,B级5例。患者术前IKDC评分均为D级,术后患者均认为获得改善或明显改善,A级9例,B级15例。      结论      采用部分腓骨长肌腱重建PLC,基本再现了三根韧带的走形,能够较好地纠正膝关节后外侧不稳定,临床效果满意。

Abstract:

Objective      To introduce surgical methods and clinical effects of functional reconstruction of posterolateral complex (PLC) by part of peroneus longus tendon.       Methods       During July 2012 to July 2014, part of peroneus longus tendon was adopted to simulate reconstruction of 3 core ligaments of PLC to treat 24 Fanelli B or C type PLC patients with posterolateral rotation instability and rupture in substantial part of ligaments in our department. All the patients showed the combined injury, and the follow-up time was beyond 1 year. The scores of preoperative and postoperative extension of knees for 0, varus of bending of knees for 30, Dail-test, and international knee documentation committee (IKDC) were compared.       Results      All patients were followed up. No iatrogenic vascular injury occurred. All patients had no extension limit of the knee joints, but had mild bending limit. Varus circumstances included 11 cases of Ⅱ degree and 13 cases of Ⅲ degree at preoperative extension of knee for 0°, 9 cases of Ⅱ degree and 15 cases of Ⅲ degree at preoperative bending of knees for 30°, 2 cases of Ⅰ degree at postoperative extension of knee for 0°, and 5 cases of Ⅰ degree at postoperative bending of knees for 30°, and the rest were negative. Dial-test showed that preoperative added tibia external rotation was equally beyond 10°, including 21 cases of grade C and 3 cases of grade D. Postoperative added tibia external rotation was less than 10, including 19 cases of grade A and 5 cases of grade B. The preoperative IKDC scores of all patients were regarded as grade D, and all patients were functionally improved or significantly improved after operation, including 9 cases of grade A and 15 cases of grade B.       Conclusion      Based on anatomy and biomechanics, part of the peroneus longus tendon is used to simulate reconstruction of 3 core ligaments of PLC, which can basically reappear the shape of 3 ligaments, preferably correct excessive external rotation and external straight instability, and improve knee function to the maximum extent.

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更新日期/Last Update: 2016-06-07