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改良麦金托什技术（经髂胫束自体移植）用于小儿前交叉韧带重建的无结全缝线锚钉固定

Modified MacIntosh (Over-the-Top Iliotibial Band Autograft) Technique for Pediatric Anterior Cruciate Ligament Reconstruction Using Knotless All-Suture Anchor Fixation.

作者信息

Richards Jarod A, Mays Logan M, Woodard David R, DeFroda Steven F, Nuelle Clayton W

机构信息

Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.

出版信息

Arthrosc Tech. 2024 Aug 27;14(2):103204. doi: 10.1016/j.eats.2024.103204. eCollection 2025 Feb.

DOI:10.1016/j.eats.2024.103204
PMID:40041360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11873512/
Abstract

Anterior cruciate ligament (ACL) injury is a significant cause of injury among pediatric patients with an increasing incidence. ACL insufficiency can lead to lifelong disability as further joint deterioration occurs in the form of meniscal and subsequently chondral pathology. Techniques for pediatric ACL reconstruction can broadly be classified as physeal-sparing and non-physeal-sparing. Bone age is frequently used when deciding which technique to employ. Patients are candidates for physeal-sparing, over-the-top iliotibial band reconstruction (i.e., modified MacIntosh II) when they have >4 years remaining before skeletal maturity. The modified Macintosh procedure provides both intra- and extra-articular rotational and translational constraint. This Technical Note describes the senior author's modified MacIntosh technique using knotless all-suture anchor fixation in a suture staple technique to mitigate risk of physeal damage.

摘要

前交叉韧带（ACL）损伤是儿科患者受伤的一个重要原因，且发病率不断上升。ACL功能不全可导致终身残疾，因为会以半月板及随后的软骨病变形式出现进一步的关节退化。儿科ACL重建技术大致可分为保留骨骺和不保留骨骺两类。在决定采用哪种技术时，骨龄经常被用到。当患者距骨骼成熟还有超过4年时，他们适合进行保留骨骺的、过顶髂胫束重建术（即改良MacIntosh II）。改良Macintosh手术提供了关节内和关节外的旋转和平移限制。本技术说明描述了资深作者使用无结全缝线锚钉固定的缝合钉技术的改良MacIntosh技术，以降低骨骺损伤风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/cd89475d93e8/gr13.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/cd89475d93e8/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/e0985007b995/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/da15283e0302/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/9b715a2bf34c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/bdbfe1488ad0/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/7f06e3c70399/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/64da887d4531/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/295f3d3a07a8/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/42861f8e585f/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/1ea0cf742daf/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/10482c3145c3/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/620cd9ba2cd6/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/22d7086a7848/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e89/11873512/cd89475d93e8/gr13.jpg

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本文引用的文献

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Major Increase in Incidence of Pediatric ACL Reconstructions From 2005 to 2021: A Study From the Norwegian Knee Ligament Register.2005 年至 2021 年，小儿 ACL 重建发生率显著增加：来自挪威膝关节韧带登记处的研究。
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