摘要
目的探讨膝关节创伤后严重功能障碍的治疗以及人工关节置换治疗这类疾病的手术适应证及手术方法。方法自1997年6月至2004年6月采用人工关节置换治疗严重创伤后晚期膝关节功能障碍18例21膝,对于其中严重创伤性关节炎无明显畸形10例12膝,采用膝关节表面置换。创伤性关节炎合并膝关节20°～40°内外翻或20°～90°固定性屈曲畸形6例7膝,膝关节完全骨性强直2例2膝,患者采用可旋转铰链式膝关节。所有患者均获得随访,时间6个月～7年,平均3.5年,采用美国特种外科医院(HospitalforSpecialSurgery,HSS)评分标准对手术疗效进行评价。结果评定膝关节术后的疼痛、活动功能、关节畸形矫正以及稳定性和肌力。术前评价均为差,术后优12膝,良7膝,可2膝,总优良率90%。患者主观满意率为100%。结论关节置换治疗膝关节创伤后晚期严重功能障碍是一种有效的方法。
Objective To study the treatment of severe dysfunction of knee joint after trauma and explore the operative indication and method for total knee replacement treating such kind of disease. Methods From June 1997 to June 2004, total knee replacement using total knee prosthesis system was carried out in 21 knees of 18 cases with severe dysfunction of knee joint at late stage after knee replacement treating knee trauma, of which 12 knees in 10 cases with severe traumatic arthritis underwent total knee surface replacement. Seven knees in six cases with traumatic arthritis combined with 20°-40°varus or valgus or 20°-90° fixity flexion deformity and two knees in two cases with completely bony ankylosis were treated with rotation hinged knee joint. All cases were followed up for mean 3.5 years, ranging from six months to seven years. The Hospital for Special Surgery （HSS） knee rating score system was used to evaluate the clinical results. Results Pain relief, function recovery, rectification of knee deformities, stability and muscle power were all poor before operation. But postoperative valuation of pain relief, function recovery, rectification of knee deformities, stability and muscle power showed excellent result in 12 cases, good in seven and fair in two, with excellence rate of 90% and rate of patient satisfaction of 100%. Conclusion The knee replacement is an effective method for treating severe dysfunction of knee joint at late stage after knee replacement treating knee trauma.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2005年第11期815-818,共4页
Chinese Journal of Trauma
