保留交叉韧带前内侧束或后外侧束与残端重建ACL的价值

叶洪战

[摘要] 目的 研究分析保留交叉韌带前内侧束或后外侧束与残端重建ACL的价值。方法 方便选取该院2015年1月—2017年10月收治80例前交叉韧带损伤患者为研究对象，29例患者为运动伤，训练伤患者为20例，21例患者为绞痛事故伤，10例患者为生活中扭伤。29例患者进行保留ACL残端四股胭绳肌腱结嵌压固定法重建治疗，18例患者进行自体带髌骨块的股四头肌腱嵌压固定法 重建，33例患者应用保留A C L 前内侧束和后外侧束双股胭绳肌腱结嵌压固定重建治疗。 结果 患者术前Lysholm膝关节功能评分为（67.23±2.12）分，随访后平均得分为（94.33±4.30）分，差异有统计学意义（t=4.33，P<0.05），可见患者膝关节稳定性提高。74例患者Lachman试验结果为阴性，5例患者为弱阳性，阳性患者为1例。72例患者膝关节疗效评定为优，8例患者疗效评定为良。经过治疗后，80例前交叉韧带损伤患者均恢复正常生活，1年后膝关节本体并无异常，关节稳定性良好。 结论 保留交叉韧带前内侧束或后外侧束与残端重建ACL具有重要临床应用价值，能够有效稳定患者膝关节功能，具有推广的意义。

[关键词] 保留交叉韧带；残端重建ACL；后外侧束

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0056-03

The Value of Reconstructing ACL by Preserving the Anterior Medial or Posterolateral Bundle of the Cruciate Ligament and the Remnant End of the Cruciate Ligament

YE Hong-zhan

Second Ward， Department of Orthopaedics and Traumatology， Tianquan Hospital of TCM， Tianquan， Sichuan Province， 625599 China

[Abstract] Objective To study and analyze the value of the reconstruction of ACL with the anterior medial or posterolateral bundle of the cruciate ligament and the remnant end of the cruciate ligament. Methods From January 2015 to October 2017， 80 patients with anterior cruciate ligament injury were selected as the research subjects， 29 cases had sports injuries， 20 cases had training injuries， 21 cases had colic accident injuries， 10 cases had sprains in life. 29 cases were treated by retaining ACL stump four shares of hamstring tendon knot pressfixation reconstructiont， 18 cases were treated with autologous femoral head four tendon patellar block pressfixation reconstruction， 33 cases of patients applied A C L to retain the anteromedial and posterolateral bundles of double stranded hamstring tendon knot pressfixation reconstruction. Results The preoperative Lysholm knee function score was （67.23±2.12）points， and the average score was （94.33±4.30）points after the follow-up， and the difference was statistically significant （t=4.33， P<0.05）， indicating that the stability of the knee joint was improved. In 74 cases， the results of Lachman test were negative， 5 cases were weak positive， 1 case was positive. The curative effect of 72 cases of knee joint was excellent， and the curative effect of 8 cases was good. After treatment， 80 cases of anterior cruciate ligament injury recovered to normal life. After 1 year， the body of the knee joint had no abnormality， and the stability of the joint was good. Conclusion Preserving the anterior medial bundle or posterolateral bundle of cruciate ligament with stump reconstruction of ACL has an important clinical value， which can effectively stabilize the function of knee joint， and it is of promotion vlaue.

[Key words] Retaining the cruciate ligament； Remnant end reconstructs ACL； Posterolateral bundle

在临床治疗中，膝前交叉韧带损伤发病率逐年升高，如何能够恢复患者膝关节本体感觉，促进骨隧道与肌腱愈合为一个重要话题[1]。为研究分析保留交叉韧带前内侧束或后外侧束与残端重建ACL的价值，方便选取该院2015年1月—2017年10月收治的80例前交叉韧带损伤患者为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的80例前交叉韧带损伤患者为研究对象，均充分知情同意，并通过伦理委员会的批准。19例患者为运动伤，训练伤患者为11例，40例患者为交通事故伤，10例患者为生活中扭伤。80例患者中，年龄范围为17～55岁，平均年龄为（37.80±3.22）岁，40例患者为农民，22例患者为学生，18例患者为体育运动爱好者。选取患者临床表现为均为跑步、登高时膝关节不稳，膝关节疼痛。……