军事训练致膝关节侧副韧带Ⅲ度损伤的手术治疗

摘要

目的 探讨手术治疗军事训练所致膝关节侧副韧带Ⅲ度损伤的方法及疗效.方法 军事训练中发生的膝关节侧副韧带Ⅲ度损伤患者16例,采用带线锚钉对侧副韧带止点损伤进行止点修复,对内侧副韧带实质部新鲜性损伤进行直接缝合修复,而陈旧性损伤采用损伤部位直接缝合+股薄肌半腱肌肌腱转位重建加强,对外侧副韧带实质部新鲜及陈旧性损伤均采用半腱肌肌腱重建的方法进行修复.术后1年采用Lysholm评分法对膝关节功能进行评估,并与术前进行比较.结果 16例患者均获随访,随访时间12～33个月,平均20.5个月.术后1年膝关节功能Lysholm评分为92.45±4.03分,与术前(56.45±11.03分)比较差异有统计学意义(P<0.05).结论 对于军事训练所致膝关节侧副韧带Ⅲ度损伤,应本着早诊断、早手术的原则,术中根据不同的损伤类型采取相应的方法,以求获得最佳的治疗效果.%Objective To explore the method and effect of surgical treatment on grade Ⅲ collateral ligament injuries caused by military training.Methods Sixteen cases of grade Ⅲ collateral ligament injuries caused by military training were involved in the present study.Injuries to insertion of collateral ligament was repaired with suture anchor, fresh rupture of medial collateral ligament parenchyma was sutured directly, old rupture of medial collateral ligament parenchyma was repaired by direct suture and strengthening with autologous semitendinosus-gracilis tendon graft, while both fresh and old rupture of lateral collateral ligament parenchyma was reconstructed with autologous semitendinosus-gracilis tendon graft.Knee function was assessed 1 year after operation by Lysholm scores and compared with that before the operation.Results All the 16 patients were followed-up for 12 to 33 months with a mean of 20.5 months.The Lysholm knee scores of 1 year after peration (92.45 ± 4.03) was significantly higher than that before operation (56.45 ± 11.03, P＜0.05).Conclusions For the grade Ⅲ collateral ligament injuries caused by military training, the treatment principle was early diagnosis and early operation, and different surgical methods should be used according to the injury types for the sake of obtaining best therapeutic effects.