Jones R E, Smith E C, Bone G E
Surg Gynecol Obstet. 1979 Oct;149(4):554-8.
Experience with complete dislocation of the knee in 22 consecutive patients during a six year period was analyzed. Major vascular complications occurred in nine of 13 extremities with anterior dislocation, one of seven extremities with posterior dislocation and none of two extremities with lateral dislocation. Liberal use of trans-femoral ateriography for diagnosis disclosed significant arterial injuries in four of 15 limbs, despite postreduction pedal pulses which were apparently normal. Limb salvage was accomplished in 20 of 21 survivors and in eight of nine with associated vascular complications. All patients demonstrated severe instability of the ligamentous structures of the knee consistent with the type of dislocation. Posterior instability was severe in all patients, an indication of disruption of the posterior cruciate ligament in every instance. Adequate follow-up information was available on 12 knees that had primary ligamentous repair, ten of which were stable to stress testing. Postoperative immobilization was accomplished by external skeletal fixation, skeletal traction or long leg posterior plaster splint.
分析了连续六年期间22例膝关节完全脱位患者的经验。13例前脱位肢体中有9例发生主要血管并发症，7例后脱位肢体中有1例发生，2例侧方脱位肢体中无1例发生。尽管复位后足背脉搏明显正常，但在15条肢体中，有4条通过经股动脉造影进行诊断时发现了严重的动脉损伤。21名幸存者中有20名肢体得以挽救，9名伴有血管并发症的患者中有8名肢体得以挽救。所有患者均表现出与脱位类型相符的膝关节韧带结构严重不稳定。所有患者均存在严重的后向不稳定，这表明每次后交叉韧带均发生断裂。对12例进行了初次韧带修复的膝关节进行了充分的随访，其中10例在应力测试中稳定。术后通过外骨骼固定、骨牵引或长腿后侧石膏夹板进行固定。
