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[膝关节后外侧不稳定]

[Posterolateral instability of the knee joint].

作者信息

Berninger M T, Drenck T C, Frings J, Krause M, Frosch K-H

机构信息

Klinik und Poliklinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.

Abteilung für Unfallchirurgie, Orthopädie und Sporttraumatologie, BG Klinikum Hamburg, Hamburg, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Apr;53(4):297-307. doi: 10.1007/s00132-024-04478-7. Epub 2024 Feb 20.

Abstract

The posterolateral corner of the knee is composed of a multilayered complex of ligamentous, musculotendinous, and capsular structures, which interact in a synergistic stabilizing manner with the central structures, particularly the posterior cruciate ligament. Injuries of the posterolateral corner are generally accompanied by rupture of the posterior cruciate ligament. Depending on the injured structures, injuries of the posterolateral corner result in posterolateral rotational instability alone (Fanelli A) or with lateral instability (Fanelli B/C). For rotational instability alone, isolated popliteus bypass is an effective procedure; with concomitant lateral instability in flexion, additional stabilization of the lateral collateral ligament is required. Most of the various available techniques are described as open reconstruction procedures. In recent years, arthroscopic techniques for posterolateral reconstruction have also been successfully developed.

摘要

膝关节后外侧角由韧带、肌腱和关节囊结构组成的多层复合体构成,这些结构与中央结构,特别是后交叉韧带以协同稳定的方式相互作用。后外侧角损伤通常伴有后交叉韧带断裂。根据损伤结构的不同,后外侧角损伤可单独导致后外侧旋转不稳定(法内利A型)或伴有外侧不稳定(法内利B/C型)。对于单纯旋转不稳定,孤立的腘肌替代术是一种有效的手术方法;对于伴有屈曲时的外侧不稳定,则需要额外稳定外侧副韧带。现有的各种技术大多被描述为开放重建手术。近年来,后外侧重建的关节镜技术也已成功开发。

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