Liu Chang-Cheng, Gao Xing, Xu Ming, Kong Zhi-Gang
Orthopaedic Research Institution, Hebei Third Hospital of Hebei Medical University, Shijiazhuang, PR China.
Orthopaedic Research Institution, Hebei Third Hospital of Hebei Medical University, Shijiazhuang, PR China.
Knee. 2017 Oct;24(5):940-948. doi: 10.1016/j.knee.2017.05.023. Epub 2017 Jul 25.
The purpose of this study was to report the clinical and functional results of patients who underwent surgical management for posterior knee dislocation associated with extensor apparatus rupture.
Posterior knee dislocations associated with extensor apparatus ruptures are defined as rare but complicated injuries, which are difficult to return to the level of activity prior to the injury. The study demonstrated a hypothesis that good knee stability and early gain of range of motion could be achieved with deliberate design of the treatment protocol and proper application of the instruments.
Fifteen patients with posterior knee dislocations associated with extensor apparatus ruptures were evaluated after reduction and repair of extensor apparatus. Following that, multiple-ligament reconstruction in association with use of a lateral knee-spanning external fixator was applied for at least six weeks. Ligament reconstructions were performed using allografts. Range of motion and knee stability were both measured at each follow-up evaluation at a mean time of 36months. The assessment was made using the Lysholm Knee Scoring Scale.
The mean Lysholm scale score was 87.6 (range 73-95), with excellent in 11 cases, good in two, and fair in two. In the final evaluation, the range of motion was a mean range of 123.4° (range 100-135).
The use of a lateral knee-spanning external fixator ensured the safety of repaired vessels, knee stability after reduction, and early rehabilitation with range of motion.
本研究旨在报告接受手术治疗的伴有伸膝装置断裂的膝关节后脱位患者的临床和功能结果。
伴有伸膝装置断裂的膝关节后脱位被定义为罕见但复杂的损伤，难以恢复到受伤前的活动水平。该研究证明了一个假设，即通过精心设计治疗方案并正确应用器械，可以实现良好的膝关节稳定性和早期活动范围的增加。
对15例伴有伸膝装置断裂的膝关节后脱位患者在伸膝装置复位和修复后进行评估。在此之后，联合使用外侧跨膝关节外固定器进行多韧带重建至少六周。韧带重建使用同种异体移植物。在平均36个月的每次随访评估中测量活动范围和膝关节稳定性。使用Lysholm膝关节评分量表进行评估。
Lysholm量表平均评分为87.6（范围73 - 95），其中11例为优秀，2例为良好，2例为中等。在最终评估中，活动范围平均为123.4°（范围为100 - 135）。
使用外侧跨膝关节外固定器可确保修复血管的安全、复位后膝关节的稳定性以及早期的活动范围康复。
