膝关节多发韧带损伤脱位伴腘动脉损伤三例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

魏宝刚 , 马秉贤 , 包呼日查 , 齐岩松 ,  徐永胜

内蒙古自治区人民医院骨关节科（呼和浩特 010017）;

Corresponding author：

徐永胜, Email: dlxyf@163.com

Keywords：

多发韧带损伤; 膝关节脱位; 腘动脉损伤; 血管修复; 韧带重建

DOI：

10.7507/1002-1892.202105119

Video：

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目的总结3例膝关节多发韧带损伤脱位伴腘动脉损伤的诊疗经验。方法 2011年10月—2018年2月，收治3例膝关节多发韧带损伤脱位伴腘动脉损伤男性患者。患者年龄分别为27、70、31岁。损伤累及双侧1例、单侧2例。血管损伤时间10、4、3 h。采用一期修复血管、二期修复韧带治疗。结果患者住院时间分别为30、5、10 周，随访时间为9.5、3.5、3.0 年。 1例患者血管修复术后下肢皮肤、皮下组织部分坏死结痂，经再次植皮后愈合；其余患者切口均Ⅰ期愈合。所有肢体均成活，随访期间无感染、血管再损伤或新鲜血栓形成。末次随访时膝关节功能恢复良好，Tegner评分、Lysholm评分及美国特种外科医院（HSS）评分均较术前明显改善。1例合并双侧腘动脉损伤者并发双侧跟腱挛缩，1例术后膝关节不稳复发再次手术。结论膝关节多发韧带损伤脱位伴血管损伤临床较少见，多学科协作、及早发现和评估血管损伤、优先处理腘动脉损伤逆转肢体缺血及固定肢体是治疗此类损伤的有效方法，能够保存肢体并改善膝关节功能。

Citation： 魏宝刚, 马秉贤, 包呼日查, 齐岩松, 徐永胜. 膝关节多发韧带损伤脱位伴腘动脉损伤三例. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(1): 41-44. doi: 10.7507/1002-1892.202105119 Copy

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1. Matthewson G, Kwapisz A, Sasyniuk T, et al. Vascular injury in the multiligament injured knee. Clin Sports Med, 2019, 38(2): 199-213.
2. Prendes CF, Gombert A. The “Real” incidence of popliteal artery injury after knee Dislocations and fractures. Eur J Vasc Endovasc Surg, 2021, 61(2): 305. doi: 10.1016/j.ejvs.2020.10.004.
3. Gregory C. Farelli. The multiple ligament injured knee: A practical guide to management. New York: Springer-Verlag, 2013: 331-341.
4. Stannard JP, Schreiner AJ. Vascular injuries following knee dislocation. J Knee Surg, 2020, 33(4): 351-356.
5. Gottlieb M, Koyfman A, Long B. Evaluation and management of knee dislocation in theemergency department. J Emerg Med, 2019. doi: 10.1016/j.jemermed.2019.09.042.
6. 马振桓, 李震, 周香林, 等. 腘动脉损伤手术修复与介入治疗的对比分析. 血管与腔内血管外科杂志, 2019, 7(3): 275-278, 309.
7. Shafe O, Moosavi J, Shishehbor MH, et al. Effect of drug-coated balloons versus bare-metal stents on endothelial function in patients with severe lower limb peripheral artery disease. Vascular, 2020, 28(5): 548-556.

Chinese Journal of Reparative and Reconstructive Surgery

膝关节多发韧带损伤脱位伴腘动脉损伤三例

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