Hastings D E
Clin Orthop Relat Res. 1980 Mar-Apr(147):22-8.
Severe knee ligament injuries are frequently underestimated, and this results in later problems of chronic instability. A history of an appropriate mechanism coupled with immediate reduction in function should arouse suspicion of a major disruption. Examination with the patient under anesthesia may be required to assess the extent of the injury. If the lesion is an isolated collateral tear, the intact cruciate ligaments prevent wide displacement. Such an injury can be managed non-operatively. A long leg plaster at 90 degrees for 2 weeks followed by 4 weeks in a cast brace with motion from 45 degrees to 100 degrees is recommended. The knee is then protected in a brace during athletic activities for approximately 6 months. Thirty collateral ligament tears have been managed in this fashion. Only one has significant residual complaints. It is emphasized that an isolated collateral ligament tear is a positive diagnosis, and associated cruciate lesions must be ruled out. The recovery is faster in those patients managed non-operatively than in those who have surgical repair. There has not been a problem with late instability.
严重的膝关节韧带损伤常常被低估，这会导致后期慢性不稳定的问题。有适当的受伤机制且功能立即下降的病史应引起对严重撕裂的怀疑。可能需要在麻醉下对患者进行检查以评估损伤程度。如果损伤是孤立的侧副韧带撕裂，完整的交叉韧带可防止广泛移位。这种损伤可以非手术治疗。建议用长腿石膏固定在90度2周，然后在可拆卸支具中固定4周，活动范围从45度到100度。然后在运动活动期间用支具保护膝关节约6个月。采用这种方式处理了30例侧副韧带撕裂。只有1例有明显的残留症状。需要强调的是，孤立的侧副韧带撕裂是一个明确的诊断，必须排除相关的交叉韧带损伤。非手术治疗的患者比手术修复的患者恢复得更快。没有出现后期不稳定的问题。
