江苏徐州高绪仁膝肩髋关节网分享 http://blog.sciencenet.cn/u/GaoXurenKnee 膝肩髋关节关节镜、关节置换、截骨矫形方向专攻

博文

严重膝关节多发韧带损伤中膝关节后内侧角的损伤模式

已有 3959 次阅读 2012-8-23 18:04 |个人分类:膝关节韧带损伤|系统分类:科研笔记| 高绪仁, 关节镜, 膝关节内侧副韧带损伤, 膝关节后内侧角损伤


     加拿大多伦多大学的Chahal J等在2010年8月份的Knee Surgery, Sports Traumatology, Arthroscopy(膝关节外科、运动创伤、关节镜杂志)上撰文,用核磁共振MRI的办法分析了严重膝关节多发韧带损伤中膝关节后内侧角的损伤模式。

      膝关节多发韧带损伤中膝关节后内侧角的损伤模式尚未见报道。作者对一个一流的创伤中心进行了一个核磁共振MRI回顾性研究,对2005年至2008年连续的27个脱位的膝关节进行了临床总结。由两位骨骼肌肉方向的主治医师级放射科医师归纳膝关节损伤后的核磁共振片子来评估膝关节后内侧角的损伤模式。在这个研究中,81%(22/27)的膝关节后内侧角有一处以上结构损伤,而63%(17/27)的膝关节具有单纯的内侧副韧带损伤。另外,在全部的病例中,膝关节内侧半月板后角的损伤都伴有半月板胫骨韧带的撕裂。67%的病例具有后斜韧带(POL)的损伤。所有在麻醉状态下具有III度松弛(内侧胫股间隙>10mm)的患者不但存在内侧副韧带损伤,而且都具有后斜韧带和半月板胫骨韧带的完全撕裂。单纯半膜肌附着点的损伤不会引起在麻醉状态下进行的体格检查临床明显的内侧松弛。本文的研究结果表明,在创伤性膝关节脱位的患者中膝关节后内侧角的损伤是非常常见的。有意思的是,麻醉状态下检查显示严重的内侧不稳以及内侧半月板后角的损伤是膝关节后内侧角损伤的重要提示信号。

 2010 Aug;18(8):1098-104. Epub 2009 Dec 15.
Injury patterns to the posteromedial corner of the knee in high-grade multiligamentknee injuries: a MRI study.
Source

University of Toronto, 4410-763 Bay Street, Toronto, ON, M5G 2R3, Canada. 

Abstract

Injury patterns to the posteromedial corner of the knee have not been previously studied in the context of multiligament kneeinjuries. We performed a retrospective magnetic resonance imaging and clinical review of a consecutive series of 27 dislocatable knees presenting to a single level-one trauma center from 2005 to 2008. Post-injury magnetic resonance imaging studies were reviewed by two fellowship-trained musculoskeletal radiologists to assess injury patterns to the posteromedialcorner. In our series, injury to at least one structure within the posteromedial corner was observed in 81% (22/27) of cases while injury to the superficial medial collateral ligament alone was seen in 63% (17/27) of cases. Furthermore, injuries to the posterior horn of the medial meniscus were associated with a tear of the meniscotibial ligaments in all cases and with a tear of the posterior oblique ligament in 67% of cases. All patients with grade III laxity (>10 mm medial opening) under an examination under anesthesia had a complete tear of the posterior oblique ligament and meniscotibial ligament in addition to a medial collateral ligament injuryInjury to the semimembranosus attachment alone was not associated with clinically significant laxity under an examination under anesthesia. Our findings demonstrate that injuries to the posteromedial cornerare common in the setting of traumatic knee dislocations. Interestingly, high-grade medial instability during an examination under anesthesia and injury to the posterior horn of the medial meniscus may be important indicators for further posteromedialcorner injury.


江苏省徐州医学院附属医院骨科  关节镜、膝关节外科、骨科运动医学方向 高绪仁 编译

 

高绪仁:每天以解决膝关节问题为乐:)

每天努力提高自己的技术和服务水平

不仅仅是解决其膝关节问题,更是给其带来希望、未来和新生!




https://blog.sciencenet.cn/blog-394169-605218.html

上一篇:2012年度“滑膜”相关国家自然基金资助项目小结
下一篇:在进行膝内侧副韧带损伤修复或重建时要注意隐神经的缝匠肌分支
收藏 IP: 49.81.32.*| 热度|

1 dulizhi95

该博文允许注册用户评论 请点击登录 评论 (0 个评论)

数据加载中...
扫一扫,分享此博文

Archiver|手机版|科学网 ( 京ICP备07017567号-12 )

GMT+8, 2024-5-12 04:39

Powered by ScienceNet.cn

Copyright © 2007- 中国科学报社

返回顶部