Department of Orthopaedic Surgery, University of New Mexico, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
Department of Orthopaedic Surgery, University of New Mexico, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
Clin Sports Med. 2019 Apr;38(2):247-260. doi: 10.1016/j.csm.2018.11.007. Epub 2019 Jan 19.
"KDIV ligamentous injuries of the knee are frequently high-energy injuries with significant soft tissue disruption, gross knee instability, and rarely are treated nonoperatively. KDIVs frequently require external fixation, but when presenting in an isolated fashion can be reconstructed in one setting. Five presentations of KDIV injury are described: closed with multitrauma/closed head injury requiring external fixation, irreducible KDIV requiring semi-emergent open reduction and repair, isolated KDIV without arterial injury undergoing 4-ligament reconstruction after regaining motion, KDIV with varus and slight thrust undergoing medial opening osteotomy before ligament reconstruction, and KDIV with failed ligaments requiring revision and posterior tibial tendon transfer."
KDIV 膝关节韧带损伤多为高能量损伤，伴有明显的软组织撕裂、严重的膝关节不稳定，很少采用非手术治疗。KDIV 通常需要外固定，但在孤立的情况下可以在一个部位进行重建。KDIV 损伤有五种表现形式：合并多发创伤/闭合性颅脑损伤需要外固定、不可复位的 KDIV 需要半紧急开放复位和修复、无动脉损伤的孤立 KDIV 在恢复运动后进行 4 韧带重建、合并内翻和轻度前推力的 KDIV 在韧带重建前进行内侧开口截骨、合并失败韧带的 KDIV 需要翻修和后胫肌腱转移。
