Objective To study the role of the anteromedial bundle ( AMB) and posterolateral bundle (PLB) of the anterior cruciate ligament ( ACL) in maintaining knee joint stability. Methods In this study,12 fresh-frozen human cadaveric knees were tested under two kinds of external loading conditions including a 100N anterior tibial load with the knee at 0°,15° ,30° ,60°and 90°of flexion; and a 5Nm pronation load with the knee at 0° , 15°and 30° of flexion. The two bunches of ligament were pulled tight that led the strain gauge to deformation, and changed output voltage value. Results In response to a 100N anterior tibial load,the situ force in the AMB was significantly greater at 60°and 90°than at full extension and 15°of flexion(P < 0. 05 ) ;the situ force in the PLB was significantly greater at full extension and 15°than at 30° ,60° and 90°of flexion(P < 0. 05) ;the situ force in the PLB was significantly greater than the AMB at full extension and 15°; the situ force in the AMB was significantly greater than the PLB at 30° ,60° and 90°. In response to a 5Nm interned tibial torques load,the situ force in the AMB was significantly greater than the PLB at 15° and 30° of flexion ( P < 0. 05 ) ; no statistical difference occurred between AMB and PLB at full extension(P >0. 05) . Conclusion Though the AMB plays an important role in the ACL,the role of PLB should, not be ignored, in maintaining anterior and internal rotational stability at low flexion angles.%目的 探讨后外侧入路钢板固定后踝骨折的手术方法及临床疗效.方法 2008年5月~2012年3月,采用后外侧入路钢板固定治疗后踝骨折37例.根据Lauge-Hansen踝关节骨折分型,旋后外旋型23例,旋前外展型6例,旋前外旋型8例.术后定期门诊随访,观察骨折愈合及踝关节功能情况.结果 本组患者手术时间为63~105min,平均82.0min;所有患者均获随访,随访时间13~17个月,平均14.5个月.所有患者切口均Ⅰ期愈合,X线片检查示所有骨折均获骨性愈合,随访期间未见内固定物移位、松动或断裂;末次随访时,踝关节功能根据Phillips踝关节评分标准,本组评分为110~150分,平均141.0分;获优21例、良好11例、一般3例、差2例;优良率为86.5%.结论 采用后外侧入路钢板固定治疗后踝骨折,创伤小,手术显露清晰,可直接地精确复位关节面,并进行稳定固定.
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