Geiger Erik J, Arzeno Alexander H, Medvecky Michael J
Department of Orthopaedics and Rehabilitation, Yale Orthopaedics/Sports Medicine, Yale University, New Haven, CT.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):E497-E502.
Dislocation of the knee is a rare phenomenon that is becoming increasingly recognized with the expansion of its definition to include knees presenting with multiligament compromise. Hinged external fixators are now considered a viable supplementary treatment option in the management of acute ligament repair or reconstruction but their use in the management of subacute or chronic tibiofemoral dislocations or subluxations is less well defined. We report a case of a hinged-knee external fixator used to facilitate and maintain reduction of a chronic coronal tibial subluxation that presented after repair of an acute knee dislocation with lateral ligament injury secondary to a motor vehicle accident. At 5-year follow-up, the patient treated with hinged external fixation had a stable joint, was able to tolerate regular aerobic exercise, was minimally symptomatic, and did not require more extensive ligament reconstruction. Although there are reports on postoperative use of hinged external fixation to maintain the reduction of chronic or subacute knee dislocations in the sagittal plane after cruciate ligament repair, there are no reports on management of subacute tibiofemoral subluxation in the coronal plane.
膝关节脱位是一种罕见现象，随着其定义的扩展以包括存在多韧带损伤的膝关节，这种现象越来越受到认可。目前，铰链式外固定器被认为是急性韧带修复或重建治疗中的一种可行的辅助治疗选择，但它们在亚急性或慢性胫股关节脱位或半脱位治疗中的应用尚不太明确。我们报告了一例使用铰链式膝关节外固定器促进并维持慢性冠状位胫骨半脱位复位的病例，该半脱位是在机动车事故继发外侧韧带损伤的急性膝关节脱位修复后出现的。在5年的随访中，接受铰链式外固定治疗的患者关节稳定，能够耐受常规有氧运动，症状轻微，且无需进行更广泛的韧带重建。虽然有关于铰链式外固定器在十字韧带修复后用于维持慢性或亚急性膝关节矢状面脱位复位的术后应用报告，但尚无关于冠状面亚急性胫股关节半脱位治疗的报告。
