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Surgical Management of the Multiple-Ligament Knee Injury

机译:多韧带膝关节损伤的外科治疗

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摘要

The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies. In this surgical technique description, we describe a reproducible method for the assessment and surgical management of a knee dislocation (KDIV) injury. Our approach includes using anatomic single-bundle cruciate ligament reconstructions with modified Bosworth technique for medial-side injuries and a combination of Müller popliteal bypass and Larson figure-of-8 techniques for posterolateral corner injuries. The orders of surgical steps is described concisely, and technical controversies such as graft choice, tunnel positioning, and sequence of graft fixation are discussed in detail.
机译:多韧带膝关节损伤的治疗是一个复杂的过程,要从充分识别损伤开始。对膝部解剖结构有透彻了解的详细的身体和放射学检查对于评估所有受损结构至关重要:前交叉韧带,后交叉韧带,包括内侧副韧带的后内侧角和包括外侧副韧带的后外侧角。这些年来,已经开发了几种外科手术技术来充分解决这些韧带不足的问题。在此手术技术说明中,我们描述了一种可重复性的方法,用于评估和评估膝关节脱位(KDIV)损伤的手术管理。我们的方法包括使用解剖型单束交叉韧带重建术和改良的Bosworth技术治疗内侧损伤,并结合Müllerpop骨旁路术和Larson 8字形技术治疗后外侧角膜损伤。简要介绍了手术步骤的顺序,并详细讨论了技术争议,例如移植物的选择,隧道的位置以及移植物固定的顺序。

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