黄迅悟 常青 赵大庆 刘蜀彬 孔祥星 汪云 100091 北京，解放军第三○九医院骨科 中华骨科杂志 1999 0 19 3


    关键词：关节镜检查；膝损伤；半月板；胫骨；缝合技术 期刊 zhgkzz 0 临床研究 fur -->


    

【摘要】目的 评价膝关节镜下由内向外半月板缝合术疗效。方法 1993年4月～1997年4月，49例经膝关节镜检确诊的多种类型半月板撕裂伤患者，做镜视下半月板缝合术，术后膝关节屈曲40°位石膏固定6周，再用支具控制膝关节在0°～90°位活动7周。术前及术后一年用Lysholm-Ⅱ评分评定膝关节功能及患者运动水平。结果 我们随访了43例患者，术前Lysholm-Ⅱ评分平均45分(36～62分)，手术一年后Lysholm-Ⅱ评分平均86分(58～98分)，总优良率83.7%。结论 半月板边缘区纵裂，跨越半月板血运区和非血运区的单纯横断、短瓣状、“T”形撕裂伤，只要经缝合可获得稳定，缝合术后可获得满意的疗效。关节镜下由内向外缝合术可使半月板撕裂伤精确复位，牢靠固定。

    Treatment for MeniscalTears With Arthroscopic Sutures, Starting From the Internal Toward the External End of theLesion

HUANG Xunwu, CHANG Qing, ZHAODaqing, et al.

    Department of Orthopaedics, 309 PLA Hospital, Beijing 100091

【 Abstract 】 Objective Toevaluate the clinical results of arthroscopic meniscal suture for the treatment of tears. Methods Forty- nine patientsunderwent meniscal repair using the method of suturing from the innermost of the teartoward the external end of the lesion from April 1993 to April 1997 were reviewed. Theknee was immobilized in 40 degrees of flexion and weight bearing was not permitted for 6weeks after operation, a brace was then used for 7 weeks, which limited the knee flexionfrom 0 to 90 degrees. Lysholm-Ⅱ rating system was used to determine the function of theknee and the patient’ slevel of activity. Results Forty- three patients were followed up. Before operation, themean Lysholm-Ⅱ scorewas 45 points (36- 62points). One year later after operation, the mean Lysholm-Ⅱ score was 86 points(58- 98 points). The excellent and good results were obtainedin 83.7% of thepatients. Conclusion Transverse, short flap and “ T” shape tears through both vascular and avascular portions,as well as longitudinal tears in vascular portions of the meniscus, if can be stabilizedby suture, satisfactory curative effect can be obtained. The technique of suture startingfrom the innermost end of the tear can provide the exact replacement and the necessarystability to healing of the meniscal tear.

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