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[膝关节的手动超声检查。诊断前交叉韧带新鲜断裂的一种全科医疗方法]

[Manual ultrasound of the knee joint. A general practice method for diagnosis of fresh rupture of the anterior cruciate ligament].

作者信息

Schwarz W, Hagelstein J, Minholz R, Schierlinger M, Danz B, Gerngross H

机构信息

Chirurgische Abteilung, Bundeswehrkrankenhaus Ulm.

出版信息

Unfallchirurg. 1997 Apr;100(4):280-5. doi: 10.1007/s001130050120.

Abstract

A prospective, arthroscopic controlled study was performed to evaluate the usefulness of mancal sonometry of the knee in the diagnosis of acute rupture of the anterior cruciate ligament (ACL). In 58 patients with an acute knee injury, a maximum of 30 days elapsed between accident and clinical examination (Lachmantest, pivot-shift/ McIntosh, 90 degrees anterior translation), manual sonometry and functional X-ray examination. Afterwards all patients were examined by arthroscopy. Nine patients showed a partial, 38 patients a total rupture of the ACL. If the ACL was completely ruptured, the average difference in anterior translation between the contralateral and the injured knee was 3.3 mm (p < or = 0.001). Statistical analysis showed high sensitivity (85%), specificity (91%) and positive predictive value (98%) for manual sonometry. Clinical examination, apparative sonometry and functional X-ray were, overall, less effective than manual sonometry in detecting ligament rupture. Manual sonometry proved to be a good and practicable method for assessing acute rupture of the ACL.

摘要

进行了一项前瞻性关节镜对照研究,以评估膝关节的手动超声检查在诊断前交叉韧带(ACL)急性断裂中的作用。在58例急性膝关节损伤患者中,事故与临床检查(拉赫曼试验、轴移试验/麦金托什试验、90度前向平移)、手动超声检查和功能X线检查之间的间隔最长为30天。之后,所有患者均接受关节镜检查。9例患者显示ACL部分断裂,38例患者显示ACL完全断裂。如果ACL完全断裂,对侧膝关节与受伤膝关节之间的前向平移平均差异为3.3毫米(p≤0.001)。统计分析显示,手动超声检查具有较高的敏感性(85%)、特异性(91%)和阳性预测值(98%)。总体而言,临床检查、仪器超声检查和功能X线检查在检测韧带断裂方面不如手动超声检查有效。事实证明,手动超声检查是评估ACL急性断裂的一种良好且实用的方法。

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