Mueller P O, Allen D, Watson E, Hay C
Department of Large Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens 30602.
J Am Vet Med Assoc. 1994 Jun 1;204(11):1793-5.
A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a direct view of the fracture was obscured by the cranial cruciate ligament. The fracture fragment was removed, and visual inspection revealed approximately half of the cranial cruciate ligament at its insertion on the intercondylar eminence to be compromised. Fourteen months after surgery, the horse had trained and had raced without lameness. Accurate evaluation of the intra-articular soft-tissue structures of the stifle is important because ligamentous and/or meniscal injuries often are the limiting factors in determining the potential for a successful outcome and future athletic performance.
一匹2岁的标准赛马驹因左后肢跛行入院。体格检查发现左股髌关节和股胫关节有明显积液，左后肢跛行程度为IV/V级。左膝关节X线检查显示胫骨髁间隆起内侧结节完全骨折。关节镜检查用于提供诊断、治疗和预后信息。采用了一种向股胫关节内侧间室的前方入路。对内侧结节进行操作时发现其不稳定，但骨折的直视视野被前交叉韧带遮挡。移除了骨折碎片，肉眼检查发现前交叉韧带在髁间隆起处的插入点约有一半受到损伤。术后14个月，这匹马已接受训练并参加比赛，且没有跛行。准确评估膝关节内的软组织结构很重要，因为韧带和/或半月板损伤往往是决定手术成功可能性和未来运动表现的限制因素。
