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find Author "魏宝刚" 2 results
  • 膝关节多发韧带损伤脱位伴腘动脉损伤三例

    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。

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  • INFLUENCE OF POSTERIOR CONDYLAR OFFSET AND ANTEROPOSTERIOR FEMOROTIBIAL TRANSLATION ON KNEEFLEXION AFTER POSTERIOR CRUCIATE-SACRIFICING SELF ALIGNMENT BEARING TOTAL KNEE ARTHROPLASTY

    Objective To observe the posterior condylar offset (PCO) changes and anteroposterior femorotibial translation, to investigate the influence of them on the maximum knee range of flexion (ROF) in patients with posterior cruciatesacrificingself al ignment bearing total knee arthroplasty (TKA). Methods The cl inical data were analyzed retrospectively from 40 patients (40 knees) undergoing primary unilateral TC-PLUSTM SB posterior cruciate-sacrificing self al ignment andbearing TKA for osteoarthritis between January 2007 and June 2009. There were 18 males and 22 females with an average age of 70.6 years (range, 56-87 years). The disease duration was 5-14 years (mean, 9.1 years). The locations were the left side in 11 cases and the right side in 29 cases. Preoperative knee society score (KSS) and ROF were 48.0 ± 5.5 and (77.9 ± 9.0)°, respectively. The X-ray films were taken to measure PCO and anteroposterior femorotibial translation. Multi ple regression analysis was performed based on both the anteroposterior femorotibial translation and PCO changes as the independent variable, and maximum knee flexion as the dependent variable. Results All incisions healed by first intention. The patients were followed up 12-19 months (mean, 14.7 months). At last follow-up, there were significant differences in the KSS (91.9 ± 3.7, t=— 77.600, P=0.000), the ROF [(102.0 ± 9.3)°, t=— 23.105, P=0.000] when compared with preoperative values. Significant difference was observed in PCO (t=3.565, P=0.001) between before operation [(31.6 ± 5.5) mm] and at last follow-up [(30.6 ± 5.9) mm]. At ast follow-up, the anteroposterior femorotibial translation was (— 1.2 ± 2.1) mm (95%CI: — 1.9 mm to — 0.6 mm); femoral roll forward occurred in 27 cases (67.5%), no roll in 1 case (2.5%), and femoral roll back in 12 cases (30.0%). By multiple regression analysis (Stepwise method), the regression equation was establ ished (R=0.785, R2=0.617, F=61.128, P=0.000). Anteroposterior femorotibial translation could be introducted into the equation (t=7.818, P=0.000), but PCO changes were removed from the equation (t=1.471, P=0.150). Regression equation was y=25.587+2.349x. Conclusion Kinematics after TC-PLUSTM SB posterior cruciate-sacrificing self al ignment bearing TKA with posterior cruciate l igament-sacrificing show mostly roll forwardof the femur relative to the tibia, which have a negative effect on postoperative range of motion. There is no correlation between PCO changes and postoperative change in ROF in TC-PLUSTM SB posterior cruciate-sacrificing self al ignment bearing TKA.

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
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