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| 題 名 | Anterior Tibia Spine Fracture in Children: Follow-Up Evaluation by Biomechanical Studies=兒童脛骨前棘骨折之膝關節生物力學評估 |
|---|---|
| 作 者 | 李永恆; 秦凌霄; 王迺輝; 侯建弘; 羅惠熙; | 書刊名 | 中華醫學雜誌 |
| 卷 期 | 58:3 1996.09[民85.09] |
| 頁 次 | 頁183-189 |
| 分類號 | 417.6263 |
| 關鍵詞 | 前十字韌帶鬆弛; 脛骨前棘骨折; 生物力學; Anterior cruciate ligament laxity; Anterior tibial spine fracture; Biomechanics; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景 對於脛骨前棘骨折的治療,目前仍有若干爭議。根據文獻,大 多數的病人日後會產生前十字韌帶的鬆弛,但對於膝關節生物力學的影響卻少 有研究。本文就是針對此一問題加以評估討論。 方法 從1989年至1994年,我們共收集78例脛骨前棘骨折的患者。病患的 平均年齡是12歲3個月,平均追蹤了47個月。我們以臨床檢查,X光攝影及 生物力學研究來評估病人。KT-1000膝關節測量儀可測量前十字韌帶的鬆弛度, 而Cybex等張動力儀則是用以測量膝部屈肌及張肌的強度。 結果 12.5%的病人有臨床不適的症狀,37.5%的病人有理學檢查的異常,而50% 的病人以KT-1000膝關節測量儀可發現有前十字韌帶的鬆弛。以Cybex等張動 力儀檢查膝關節肌肉強度,我們發現屈肌肌力的減少較伸肌嚴重。 結論 輕度脛骨前棘骨折的病人,若未接受適當的治療,可能會造成日後前十 字韌帶的鬆弛及膝部肌力的減少。但即使是重度的患者,若接受適當的手術治 療仍可恢復接近正常的功能。所以正確的診斷及適當的治療是十分重要的。 |
| 英文摘要 | Background. The treatment of anterior tibial spine (ATS) fracture in children is in controversy. Previous studies have shown that most of the children who sustained ATS fractures have objective evidence of the anterior cruciate ligament (ACL) laxity at follow-up, but detailed biomechanical analysis of the knee joint has seldom been performed. Methods. Eight ATS fractures in children at a mean age of 12 years were treated from 1989 to 1994. Two were of Meyer's classification type I, 3 were of type II, and 3 were of type III. The treatment varied from casting to open reduction & internal fixation (ORIF) by pulling through suture or biofix absorbable screw. Patients were followed with radiological, clinical and biomechanical analysis. KT 1000 knee arthrometer was used to evaluate the laxity of ACL. Cybex isokinetic machine was used to evaluate knee extensor and flexor strength. Results. During an average follow-up period of 47 months, all fractures showed to unite well on X-ray except 1 untreated type I fracture who had malunion. Only one had subjective complaint of instability, but 3 had clinical signs of instability. Objective evidence of laxity, determined by KT-1000 arthrometer, was noted in 4 patients. Decreased muscle strength, determined by Cybex isokinetic machine, was more prominent in hamstrings than in quadriceps. Conclusions. Patients with milder ATS fracture (type I & II), if treated inappropriately, may still result in ACL laxity and knee muscle strength deficiency. Type III ATS fractures, if treated well by ORIF, tend to recover nearly normal ACL function and muscle strength. |
本系統中英文摘要資訊取自各篇刊載內容。