| 汤明,王寒琪,李谓林,等.应用Fast-fix 360全内缝合技术修复半月板Ramp区损伤的临床研究.骨科,2020,11(3): 186-191. |
| 应用Fast-fix 360全内缝合技术修复半月板Ramp区损伤的临床研究 |
| Application of Fast-fix 360 all-inside suture technique to repair the tear of the Ramp area of meniscus |
| 投稿时间：2020-03-15 |
| DOI：10.3969/j.issn.1674-8573.2020.03.002 |
| 中文关键词: Ramp区 半月板损伤 关节镜 缝合术 |
| 英文关键词: Ramp area Meniscus injury Arthroscopy Suture technique |
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| 中文摘要: |
| 目的 探讨应用Fast-fix 360全关节内缝合技术修补半月板Ramp区损伤的方法和疗效。方法 2016年10月至2018年4月，中部战区总医院骨科足踝与运动医学中心使用Fast-fix 360缝合技术修补经镜下确诊为内侧半月板Ramp区损伤病人15例，其中男14例，女1例，平均年龄为23.6岁，病人均合并前交叉韧带（anterior cruciate ligament, ACL）断裂，均予以一期行ACL自体腘绳肌单束重建，6例合并外侧半月板损伤亦同期处理。术后行膝关节标准化功能康复。收集病例手术时间、术中出血量、术后并发症情况；术前、术后半年、术后1年的Lysholm膝关节评分、国际膝关节评分委员会（International Knee Documentation Committee, IKDC）评分；术后半年、1年分别复查患膝关节MRI，评估Ramp区损伤修复情况。结果 病人随访13~26个月（平均17.8个月）。手术时间为（90.8±21.4） min，术中出血量为（50.5±10.6） ml。术后2例病人移植肌腱供区伤口浅表感染，经延长换药后均愈合；无伤口深部感染及膝关节感染；未出现腘窝血管神经损伤情况。术后半年及1年的Lysholm膝关节评分、IKDC评分均显著高于术前，差异均有统计学意义（P均<0.05）。术后半年MRI评估Ramp区的愈合率为73.3%，术后1年其愈合率提高至86.7%。结论 使用Fast-fix 360全关节内缝合技术修补半月板Ramp区损伤，同时一期重建ACL，可获得较满意的临床疗效，方法简单、手术时间短，可作为半月板Ramp区损伤的一种常规修复方法。 |
| 英文摘要: |
| Objective To explore the method and efficacy of Fast-fix 360 in repairing the Ramp area tear of meniscus with all-inside suture. Methods From October 2016 to April 2018, 15 cases of medial meniscus injury in the Ramp area Arthroscopy diagnosed arthroscopically were treated by Fast-fix 360 suture technique in the Department of Orthopaedics, Ankle and Sports Medicine Center, Central Theater Command General Hospital of the Chinese People's Liberation Army, including 14 males and 1 female with average age of 23.6 years. All the patients were accompanied with anterior cruciate ligament (ACL) rupture, undergoing ACL single bundle reconstruction with autograft hamstring, and concomitant lateral meniscus injury in 6 cases was also treated simultaneously. Knee joint functional rehabilitation was performed after operation. The operation time, intraoperative blood loss and postoperative complications were collected. Lysholm knee score, International Knee Documentation Committee (IKDC) score before surgery, half a year after surgery, and 1 year after surgery were compared. The MRI of knee was reviewed half a year and one year after the operation to assess the repair of the injury in the Ramp area. Results The patients were followed up for 13 to 26 months (average 17.8 months). The operation time was (90.8±21.4) min, and the intraoperative blood loss was (50.5±10.6) ml. The superficial infection of the wound in the donor area of tendon transplantation was found in 2 patients after operation, and the wound healed after prolonged dressing change. No deep wound infection and knee joint infection occurred. No vascular nerve injury occurred. The Lysholm knee score and IKDC score were significantly higher six months and one year after operation than those before the operation (all P<0.05). The healing rate of Ramp area evaluated by MRI was 73.3% 6 months after surgery, and increased to 86.7% one year after surgery. Conclusion Application of Fast-fix 360 to repair the Ramp area tear with reconstructing the ACL rupture at the same time can obtain satisfactory clinical effect. Moreover, this can be used as a conventional repair method of the Ramp area damage for its simple procedure and short operation time. |
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