| 金文铭,向杜磊,沈阳,等.保残双束重建技术在军事训练致后交叉韧带损伤中的应用.骨科,2022,13(3): 218-221,228. |
| 保残双束重建技术在军事训练致后交叉韧带损伤中的应用 |
| Application of Double Bundles Reconstruction Technique in Posterior Cruciate Ligament Injury Caused by Military Training |
| 投稿时间：2022-02-20 |
| DOI：10.3969/j.issn.1674-8573.2022.03.005 |
| 中文关键词: 军事训练伤 后交叉韧带 双束重建 保残重建 |
| 英文关键词: Military training injury Posterior cruciate ligament Double bundle reconstruction Residual reconstruction |
| 基金项目:沈阳联勤保障中心自选科研项目（2020-485） |
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| 中文摘要: |
| 目的 探讨保残双束重建技术治疗军事训练致后交叉韧带（posterior cruciate ligament，PCL）损伤的临床疗效。方法 回顾分析2018年12月至2020年12月北部战区总医院骨科收治的18例膝关节PCL损伤军人病例的临床资料，在膝关节镜下应用自体半腱肌腱、股薄肌腱联合腓骨长肌腱前半部分双束双隧道保残重建PCL。其中，男14例，年龄为（28.5±5.2）岁（18~40岁）；女4例，年龄为（21.5±4.5）岁（15~34岁）。PCL损伤均由于军事训练导致，国际膝关节文献委员会（IKDC）评分为（61.37±8.49）分，改良Lysholm膝关节评分为（62.20±5.67分）；膝关节活动度为95.83°±8.15°。结果 手术时间为（90.7±5.7）min（80~120 min）。术后切口均一期愈合。所有病例均获随访，随访时间为（12.0±1.0）个月。末次随访时，后抽屉试验阳性1例，反Lachman试验阳性1例。术后IKDC评分为（84.67±3.67）分，改良Lysholm评分为（90.37±4.49），均显著优于术前，差异有统计学意义（P＜0.05）。术后1个月膝关节活动度为83.5°±8.7°，末次随访时为115.3°±11.4°，术后末次随访的临床数据与术前比较，差异存在统计学意义（P＜0.05）。术后MRI、三维CT复查示重建PCL形态及位置满意。结论 应用保残双束重建技术治疗军事训练致PCL损伤，疗效满意。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of preserving double-bundle reconstruction technique in treating posterior cruciate ligament (PCL) injury caused by military training. Methods The clinical data of 18 military patients with PCL injury admitted to the Department of Orthopedics of Northern Theater Command General Hospital from December 2018 to December 2020 were retrospectively analyzed. The PCL was reconstructed by double bundles and double tunnels in the front half of the prefibular tendon with autotendon semitendinogracilis tendon combined with prefibular tendon under knee arthroscopy. There were 14 males aged (28.5±5.2) years (18-40 years) and 4 females aged (21.5±4.5) years (15-34 years). PCL injuries were all caused by military training. IKDC score was 61.37±8.49 and Lysholm knee score was 62.20±5.67. The range of motion of knee joint was 95.83°±8.15°. Results The operation time was (90.7±5.7) min (80-120 min). All the incisions healed in one stage. All patients were followed up for (12.0±1.0) months. At the last follow-up, 1 case was positive for the back drawer test and 1 case was positive for the reverse Lachman test. The IKDC score of postoperative patients was 84.67±3.67, and the modified Lysholm score was 90.37±4.49, which were significantly better than those before surgery, with statistical significance (P＜0.05). The range of motion of knee joint was 83.5°±8.7° at 1st month after surgery, and 115.3°±11.4° at the last follow-up. There was statistical difference between the clinical data of the last follow-up and the preoperative data (P＜0.05). Postoperative MRI and 3D CT reexamination showed satisfactory morphology and location of reconstructed PCL. Conclusion The technique of preserving double-bundle reconstruction is effective for PCL injury caused by military training. |
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