Slocum D B, James S L, Larson R L, Singer K M
Clin Orthop Relat Res. 1976 Jul-Aug(118):63-9.
A simplified test for anterolateral rotary subluxation of the knee is largely based on the concepts described by Galway and McIntosh although performed in a different manner. The examiner places the right hand gently on the lateral side of the knee with the thumb overlying the posterior aspect of the fibula and the index finger palpating the anterolateral aspect of the joint line to determine the the tibiofemoral relationship. The left hand embraces the lateral side of the distal end of the femur with the thumb over the posterior aspect of the lateral femoral condyle. With equal pressure on the lateral femoral condyle and fibular head the knee is pushed gently forward into flexion. When anterointernal tibial luxation is present, a reduction phenomenon is felt as the knee passes into the 25 to 40 degree flexion range. This may occur as a sudden palpable and occasionally audible repositioning which is responsible for such terminology as a "pivot shift" or "jerk sign." We have experienced many instances where the reduction phenomenon is more subtle and is determined by palpation alone. The pathologic mechanics are determined by observations at surgery in 45 patients with a positive test. This test has improved our diagnositc ability and is easly taught to those unfamiliar with knee joint disorders.
一种用于检测膝关节前外侧旋转半脱位的简化试验，很大程度上基于戈尔韦和麦金托什所描述的概念，尽管操作方式有所不同。检查者将右手轻轻放在膝关节外侧，拇指置于腓骨后方，食指触摸关节线的前外侧以确定胫股关系。左手环抱股骨远端外侧，拇指置于股骨外侧髁后方。在对股骨外侧髁和腓骨头施加同等压力的情况下，将膝关节轻轻向前推使其屈曲。当存在胫前内侧脱位时，在膝关节屈曲至25至40度范围时会感觉到复位现象。这可能表现为突然可触及且偶尔可听到的重新定位，这就是“轴移”或“急拉征”等术语的由来。我们遇到过许多情况，其中复位现象更为微妙，仅通过触诊来确定。通过对45例该试验呈阳性的患者进行手术观察来确定其病理力学机制。该试验提高了我们的诊断能力，并且很容易教授给不熟悉膝关节疾病的人。
