首页 > 文献资料
-
膝部韧带损伤愈合机制及其组织工程学治疗进展
随着我国人民生活水平的不断提高,全民健身及体育运动的职业化得到空前的发展,但随着人们体育运动的增加,韧带损伤在肌肉骨骼系统病变中所占的比例亦逐年增高,其中大部分为膝部韧带损伤.90%膝部韧带损伤发生在前交叉韧带(anterior cruciate ligament,ACL)和内侧副韧带(medial collateral ligament,MCL).其导致的劳动能力及运动能力的丧失给社会带来了巨大损失.尽管膝部韧带损伤的发生率较高,但其临床处理措施仍存在争议[1].为了研究出更新更好的促进韧带愈合的方法,深入了解韧带损伤、愈合、重建的内部机制尤为重要[2].本文将膝部韧带损伤愈合机制及治疗韧带损伤的新兴生物学技术做一综述.
-
初次全膝关节置换术中内侧副韧带损伤的诊治研究现状
全膝关节置换术（ total knee arthroplasty，TKA）已经使用很多年，但它绝不是没有风险的手术［1］。初次TKA术中医源性内侧副韧带（ medial collateral ligament，MCL）损伤是一种并不常见的并发症，文献报道其发生率在（0．43％～2．7％）［2－4］。但是一旦发生，若处理不当，常常会导致内外侧不平衡及关节不稳，从而加速垫片磨损及导致关节置换手术失败［5］。因此，正确及合理地处理医源性MCL损伤是至关重要的。目前对于 MCL 损伤在运动医学领域的研究颇多，但是初次TKA术中医源性MCL的损伤并没有公认一致的处理方法。本文就医源性MCL损伤的处理及其相关问题的研究进行综述。
-
陈旧性十字韧带和侧副韧带断裂康复治疗探讨
Objective To investigate therapeutic method for old rupture of cross ligament and collateral ligament of the knee. Method Reduce and fix the tibia migrated to anterior and posterior anatomically with three sets of Charnley articulated splints. Reconstruct cross ligament and collateral ligament with the tendon of semitendinosus. Result Clinical symptoms disappeared in 15 cases and normal function resumed; 9 cases had different degree of symptoms after following up for 7 months to three years and 5 months. Conclusion It is an effective method to reduce tibia femoral and patellar femoral joints anatomically, reconstruct cross and collateral ligaments and resume biological function.
-
影响胫骨平台骨折疗效的因素
64 cases of tibia platform fracture were received and treated from February1994 to December 2000. The patients were guided for rehabilitation treatment as early function exercise and herb washing esc, the effects were satisfactory and it is reported as following. 1 Objects and methods 1.1 Objects 64 cases,39 male,25 female, aged 16～ 72 years, 35 cases were at the left and 29 were at the right. 52 cases were treated in one week and 12 were from one week to two weeks.The fractures were of three types: There were 37 cases of exstrophy type, Degree I: Split fracture or compress fracture of tibia external condyle with little or no transportation. The indented articular facet of the compress was no more than 0.5 cm. There were 15 cases of Degree I in the group. Degree II: 1/3 articular facet at the outside of the external condyle was of split fracture and there were external transportation, the indentation of the internal 2/3 articular facet caused by the external condyle of the femur was no more than 1.0 cm. There were 13 cases of degree II in the group. Degree III: Fracture on both condyles and there were 7 cases of Degree III in the group. There were 18 cases of entropion type and 9 cases of vertical type in the group. 1.2 Methods ( 1) Non- operation treatment ① The lower limbs were fixed with plaster support for two weeks, after swelling at the knee joints disappeared, legs were fixed for another 2～ 4 weeks with plaster support or tube support, there were 30 cases in the group and the method was suitable for Degree I and II of the exstrophy type and entropion or vertical types with little transportation.② Bone traction for 2 weeks, and 2～ 4 weeks of lower limb plaster support or tube support, or continual bone traction combined with early function exercise, there were 9 cases in the group and the method was suitable for Degree III and IV of the exstrophy type, entropion and vertical types with major transportation.( 2) Operation treatment ① Open reduction and inner fixation: 25 cases.② Treating the knee joint combined wounds: 3 cases of meniscus extirpation, 3 cases of inner collateral ligament repairing, one case of external collateral ligament repairing, 2 cases of anterior cruciate ligament repairing and one case of posterior cruciate ligament repairing.( 3) Rehabilitation treatment:① Quadriceps femoris muscle isometric contraction exercises from the third day after operation and plaster fixation, 20～ 30 times for each group and 40～ 60 groups for each day. The intensity was added gradually. ② Herb washing was added, it may be performed in two weeks after stitches taking out or plaster fixing, the prescript was as the following:Chuan qiong 15g,Red peony root 15g,Chinese angelica 15g,Cassia twig 15g,Two tooth achyranthes root 15g,Safflower 20g,Halite 15g,Licorice root 15g,Frankincense 15g,Myrrh 15g,Staghorn clubmoss herb 25g and Tuberculate speranskia herb 25g. Twice a day and 30 minutes for each time, each dose may be used for two days. ③ Knee joint function exercise with the help of the CPM two weeks after plaster fixation or operation, slight passive movement at early period may enhance local blood circulation and reduce the possibility of joint adhesion, passive exercise with greater ranges may be performed for the knee joints after four weeks.
-
缝线锚钉治疗膝关节内侧副韧带附丽点损伤
膝关节内侧副韧带(medial collateral ligament,MCL)损伤临床常见,小腿外展使膝关节突然外翻町引起MCL损伤,多见于高能量的交通伤所致的膝关节多发韧带损伤中.
