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題名 | Surgical Experience in Complete Traumatic Knee Dislocation=外傷性膝關節脫臼的外科治療經驗 |
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作者 | 張益彰; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 25:5 民81.09-10 |
頁次 | 頁1383-1389 |
分類號 | 416.61 |
關鍵詞 | 外科治療; 外傷性膝關節脫臼; |
語文 | 英文(English) |
中文摘要 | 長庚紀念醫院林口院區及沙鹿童綜合醫院骨科從民國71年9月至民國79年7月一共治療15例的外傷性膝關節脫臼:病患平均年齡為31歲,平均追踪3年3個月,而所謂脫臼是前後十字韌帶均斷裂,並排除骨折性脫位。其中三例併有血管窘迫;兩例有總腓神經受損。本系列最常見的是後外側方脫臼,最常見的原因是車禍。 我們的結論是:對血管窘迫現象應提高警覺,儘速行復位術,如有懷疑,應進行血管攝影;總腓神經受損原則上不行探查術:韌帶斷裂以在受傷後五天到二週修補為宜。我們在主張修補全部側韌帶;當十字韌帶斷在近骨處時,宜行穿越術並修補全部韌帶;當十字韌帶斷在中斷時,宜以臏骨韌帶行重建術並只重建後十字韌帶。本系列中,73%獲得良好的功能結果。 |
英文摘要 | The results of surgical treatment for ligamentous injuries in fifteen cases of complete traumatic knee dislocation were reviewed from Nov., 1982 to July, 1990. Both anterior and posterior cruciate ligaments ( ACL and PCL ) were torn in our series and all cases of pure fracture dislocation excluded. There were three cases of popliteal vascular embarrassment and two cases of peroneal nerve injury. The average age is 31 years old, ranging from 17 to 56 years old. The average follow up time is three years and three months with a minimum of one year. Except for one open case and two cases with soft tissue defect, the remaining 12 cases underwent early selective ligament repair during five to fourteen days after injury. All cases of the collateral ligament were repaired in our series. When cruciate ligaments near the bony attachment were torn pulling through procedure with repair of both cruciate ligaments is recommended. The range of motion ( ROM ) is usually excellent after pulling through procedure, but clinical instability may occur. Sometimes when cruciate ligaments tear at midsubstance, we favor the Clancy method and only reconstruct the posterior cruciate ligament to prevent graft adhesion and decrease infection rate. The stability after Clancy method are usually excellent, but the decrease in ROM may occur. According to Lysholm knee scoring scale, 73% showed the excellent and good functional result in our series. Early selective operative repair is recommended for ligamentous injuries in complete traumatic knee dislocation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。