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复杂多韧带膝关节损伤的手术治疗:病例报告

Surgical Management of Complex Multiligament Knee Injury: Case Report.

作者信息

Baeza Ramon Alonso Prieto, González Fernando González, Aragon Fernando Hernández, Pérez David Alfonso Servín, Ortiz Nadia Karina Portillo, Carrera Andrés Manuel García, Madrid Arturo Aguirre, Nafarrate Edmundo Berumen

机构信息

Orthopedic Surgeon, Star Médica Chihuahua Hospital, Perif. de la Juventud 6103, Fracc. El Saucito 31110, Chihuahua, Chihuahua, Mexico.

Orthopedic Surgeon, Christus Muguerza del Parque Hospital, de la Llave St. No. 1419, Office 9, Col. Centro 31000, Chihuahua, Chihuahua, Mexico.

出版信息

Case Rep Orthop. 2024 Oct 19;2024:2594659. doi: 10.1155/2024/2594659. eCollection 2024.

Abstract

Multiligament knee injuries (MLKIs) frequently require immediate intervention to prevent severe complications, including vascular injury. We present the case of a 51-year-old male who sustained a traumatic right knee dislocation following a motor vehicle accident. The patient exhibited significant tibiofemoral dissociation with Grade 3 instability, classified as Schenck KD IV. Immediate reduction and external fixation were performed, followed by definitive surgical management, which included fibular sling, MPFL and MCL repair, and double-bundle and double-tunnel ACL and PCL reconstruction with looped proximal tibial fixation. The patient showed an excellent early postoperative outcome, with minimal edema, manageable moderate pain, and a full range of motion by the 30-day follow-up. This case underscores the effectiveness of combining fibular sling, MPFL, and MCL, with anatomical double-bundle ACL and PCL reconstruction in the treatment of complex MLKIs. The level of evidence is IV.

摘要

多韧带膝关节损伤(MLKIs)常常需要立即干预以预防包括血管损伤在内的严重并发症。我们报告一例51岁男性患者,其在机动车事故后发生右膝外伤性脱位。患者表现出明显的胫股关节分离,伴有3级不稳定,分类为申克KD IV型。立即进行了复位和外固定,随后进行了确定性手术治疗,包括腓骨吊带、内侧髌股韧带(MPFL)和内侧副韧带(MCL)修复,以及采用胫骨近端环扎固定的双束和双隧道前交叉韧带(ACL)和后交叉韧带(PCL)重建。患者术后早期结果极佳,30天随访时水肿轻微、中度疼痛可控制且活动范围完全正常。本病例强调了在治疗复杂多韧带膝关节损伤时,联合使用腓骨吊带、内侧髌股韧带和内侧副韧带以及解剖学双束前交叉韧带和后交叉韧带重建的有效性。证据级别为IV级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a80/11512645/c09a92601f4e/CRIOR2024-2594659.001.jpg

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