Krackow K A, Vetter W L
Am J Sports Med. 1981 Jul-Aug;9(4):233-9. doi: 10.1177/036354658100900408.
Five principles to reestablish static ligamentous stability are introduced, including secure, temporary, tibiofemoral fixation to protect against early postoperative stretch or disruption. The necessity for emphasizing this point is demonstrated by a cadaver study. Knee motion in and out of long leg plaster casts was carefully studied in necropsy specimens. Casts applied over minimal or no padding allowed significant varus-valgus, anterior, posterior, and rotatory motion at the knee when manipulated manually. Medial opening to valgus stress ranged from 64 to 100% after casting as compared to the amount of instability present prior to casting. Legs with normally contoured thighs were not protected against anterior instability after casting, and an average of 48% of precasting rotational instability remained after casting. We believe that these results are relevant to much knee ligament surgery. Current means for solving the problems posed by cast immobilization alone, including case examples, are discussed.
介绍了重建静态韧带稳定性的五项原则，包括可靠、临时的胫股固定，以防止术后早期拉伸或断裂。一项尸体研究证明了强调这一点的必要性。在尸检标本中仔细研究了长腿石膏固定期间及去除后的膝关节活动情况。在最少或没有衬垫的情况下应用石膏，手动操作时膝关节会出现明显的内翻-外翻、前后和旋转运动。与石膏固定前的不稳定程度相比，石膏固定后 valgus 应力导致的内侧开口范围为 64%至 100%。大腿外形正常的腿部在石膏固定后无法防止前向不稳定，且石膏固定后平均仍保留 48%的固定前旋转不稳定。我们认为这些结果与许多膝关节韧带手术相关。讨论了当前单独解决石膏固定所带来问题的方法，包括病例示例。
