頁籤選單縮合
題名 | Discoid Meniscus of the Knee Joint=盤狀膝關節軟骨 |
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作者 | 劉華昌; 鍾瑞璋; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 18:2 1985.06[民74.06] |
頁次 | 頁115-120 |
分類號 | 416.61 |
關鍵詞 | 盤狀膝關節軟骨; |
語文 | 英文(English) |
中文摘要 | 股骨與脛骨之間的膝關節,正常的情況下在內側及外側各有1個半月狀軟骨。作者經驗22個病人25個膝關節,其半月狀軟骨為盤狀畸形,臨床上有疼痛(60%),McMurray徵候陽性(60%),破裂側壓痛(40%),活動時咔擦聲(28%),關節積血(24%),大腿4頭肌萎縮(13.6%)等等症狀及徵候。22位病人中男女各半,年齡從13到57歲(平均27.6±10.3歲),發病之誘因為運動7人(32%),交通事故5人(23%),跌倒、扭傷各1人,但無外傷記錄者有8人(36%)。有症狀到住院共拖了2年4個月。臨床診斷正確者28%,餘15膝用關節鏡才能確定診斷,而有3膝在鏡檢之後僅知有病變的情況下開刀證實為盤狀軟骨。治療方法為盤狀軟骨之全切除。街後之主要合併症為關節積水;活動範圍受限制等。在術後平均的42個月的迫踪檢查中症狀消除,效果良好。 |
英文摘要 | Normal meniscus, located between the femur and the tibia, is semilunar in shape, but 25 disc-shaped menisci were observed in a total of 22 patients, 11 male and 11 female. Such discoid menisci cause internal derangements of the knee. Clinical manifestations include pain on full flexion or full extension (60%), positive McMurray sign (60%), tenderness over the joint line of the affected side (40%), click (28%), hemarthrosis (24%) and quadriceps atrophy (13.6%). Patient age ranged from 13 to 57 years (average 27.6±10.3 years). The causes of onset were sports participation (32%), traffic accident (23%), a fall for one patient and a sprain for another. However eight patients (36%) had no history of trauma. A delay of 28 months was found from onset to hospitalization. Clinical diagnosis was correct in only seven cases (28%). The remaining 15 were correctly diagnosed by arthroscopy. In three knees, obstruction prevented the arthroscope from entering the lateral component of the knee obstruction. A second arthrotomy confirmed the existence of thick discoid menisci. Treatment for these symptomatic discoid menisci is total excision. Postoperative complications included effusion, limited range of motion and pain in one patient each. Three patients who had had instability before operation still had the same deficit. Otherwise, in a follow-up period averaging 42 months, the patients had no particular complaints and the results were quite satisfactory. |
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