前交叉韧带断裂合并内侧副韧带断裂分期治疗的临床研究

摘要

目的：研究并探讨前交叉韧带断裂合并内侧副韧带断裂的临床治疗方法及效果。方法60例前交叉韧带断裂合并内侧副韧带断裂患者,内侧副韧带断裂程度分别为Ⅱ度断裂、Ⅲ度断裂,21例内侧副韧带Ⅱ度断裂患者经3~4周制动后行前交叉韧带重建手术；15例内侧副韧带Ⅲ度断裂患者伤后2周内行前交叉韧带重建再制动6~8周为A组。24例内侧副韧带Ⅲ度断裂患者于伤后10 d内行内侧副韧带缝合带线铆钉内固定支具保护下功能锻炼3个月后行前交叉韧带重建为B组,比较内侧副韧带Ⅱ度断裂患者治疗前后的膝关节功能Lysholm评分及内侧副韧带Ⅲ度断裂患者不同治疗时机治疗前后Lysholm评分情况。结果21例内侧副韧带Ⅱ度断裂患者治疗后的Lysholm评分(84.19±18.95)分,较治疗前的(52.65±11.37)分明显提高,差异具有统计学意义(P<0.05)。在内侧副韧带Ⅲ度断裂患者中, A组、B组患者治疗后的Lysholm评分分别为(73.45±9.57)、(82.61±10.82)分,均较治疗前的(47.81±12.68)、(46.97±12.39)分明显提高(P<0.05),且B组治疗后的Lysholm评分高于A组,差异均具有统计学意义(P<0.05)。结论前交叉韧带断裂合并内侧副韧带断裂患者的临床治疗应根据其内侧副韧带断裂情况选择相应的治疗方案,Ⅱ度断裂患者应先保守治疗,再实施前交叉韧带重建手术,而Ⅲ度断裂患者则应进行分期手术治疗。%ObjectiveTo research and investigate clinical treatment measures and effect for anterior cruciate ligament rupture complicated with medial collateral ligament rupture.MethodsThere were 60 patients with anterior cruciate ligament rupture complicated with medial collateral ligament rupture, along with degree Ⅱ and degree Ⅲ medial collateral ligament rupture. After 3~4 weeks of immobilization, 21 patients with degree Ⅱ medial collateral ligament rupture received anterior cruciate ligament reconstruction. 15 patients with degree Ⅲ medial collateral ligament rupture received anterior cruciate ligament reconstruction within 2 weeks as group A, followed by 6~8 weeks of immobilization. Alternatively, 24 patients with degree Ⅲ medial collateral ligament rupture received medial collateral ligament suture zone line rivet internal fixation within 10 d as group B, followed by anterior cruciate ligament reconstruction after 3 months of functional training under protection. Comparison was made on knee joint function Lysholm scores before and after treatment in patients with degree Ⅱ medial collateral ligament rupture, and Lysholm scores before and after treatment in different time points in patients with degree Ⅲ medial collateral ligament rupture.ResultsThe 21 patients with degree Ⅱ medial collateral ligament rupture had obviously higher Lysholm score after treatment as (84.19±18.95) points than (52.65±11.37) points in before treatment, and the difference had statistical significance (P<0.05). Among patients with degree Ⅲ medial collateral ligament rupture, both groups A and B had much higher Lysholm scores after treatment as (73.45±9.57) and (82.61±10.82) points than (47.81±12.68) and (46.97±12.39) points before treatment (P<0.05). Group B also had higher Lysholm score after treatment than group A, and their differences all had statistical significance (P<0.05). ConclusionClinical treatment for anterior cruciate ligament rupture complicated with medial collateral ligament rupture patients ought to be based on their medial collateral ligament rupture degree. Patients with degree Ⅱ rupture is suitable for conservative therapy followed by anterior cruciate ligament reconstruction, while patients with degree Ⅲ rupture should be given staging operation for treatment.