Shakespeare D T, Rigby H S
J Bone Joint Surg Br. 1983 Aug;65(4):383-7. doi: 10.1302/0301-620X.65B4.6874707.
A retrospective series of 272 operatively proven bucket-handle tears of the meniscus has been studied to define the natural history of the tear and to assess the accuracy of arthrography as a diagnostic technique. A simple twist, or a sporting injury accounted for most tears in the 196 patients on whom information was sufficient to allow analysis. There was, however, either no known trauma or merely a history of crouching in 20 per cent of patients. These were distributed evenly throughout the age range. Most of the 272 patients presented either with a locked knee (43 per cent) or with a history of locking (37 per cent). Fifty per cent of those with a previous history of locking but who were clinically unlocked at the time of operation, had displaced bucket-handle tears, indicating that unlocking of the knee joint frequently represents anterior extension of the tear, rather than relocation of the displaced fragment of meniscus. Significant meniscal tears were identified in 77 per cent of the 187 arthogram reports that were studied. Most errors in diagnosis seemed to occur when the separated fragment was hidden in the intercondylar notch and the peripheral rim was misinterpreted as an intact meniscus.
对272例经手术证实为半月板桶柄状撕裂的病例进行了回顾性研究，以明确撕裂的自然病程，并评估关节造影作为一种诊断技术的准确性。在196例有足够信息可供分析的患者中，大多数撕裂是由简单扭转或运动损伤引起的。然而，20%的患者既无已知外伤史，也仅有蹲姿史。这些患者在整个年龄范围内分布均匀。272例患者中，大多数表现为膝关节交锁（43%）或有交锁病史（37%）。在那些既往有交锁病史但手术时临床未交锁的患者中，50%有移位的桶柄状撕裂，这表明膝关节解锁通常代表撕裂向前延伸，而非半月板移位碎片复位。在研究的187份关节造影报告中，77%发现了明显的半月板撕裂。大多数诊断错误似乎发生在分离的碎片隐藏在髁间切迹中，而周边边缘被误判为完整半月板时。
