中国修复重建外科杂志

中国修复重建外科杂志

膝关节脱位后内侧结构及后外侧角损伤分期分型及诊治体系

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目的 综述膝关节脱位(knee dislocation,KD)后内侧结构及后外侧角损伤分期分型及诊治的研究进展,以期为临床工作提供指导。 方法 广泛查阅近年国内外相关 KD 后内侧结构及后外侧角的分期分型及诊断、治疗文献,并进行总结。 结果 目前临床 KD 分型标准主要有根据受伤能量大小分型、Kennedy 分型、改良 Schenck 分型,但均不完善;未对 KD 中的多发韧带损伤进行分期、分型,也未针对不同损伤分型提出规范治疗方案。而 KD 多发韧带损伤华西分期分型(Hua Xi Knee Dislocation and Multiple Ligament Injury,HX-KDMLI)诊断及规范化治疗体系对后内侧结构及后外侧角损伤进行分期、分型,并提出针对性治疗方案。 结论 目前关于 KD 后内侧结构、后外侧角损伤的分期分型诊断与治疗仍无统一意见,HX-KDMLI 体系对以上两方面进行了系统描述,对 KD 的诊治具有一定参考价值。

Objective To review the research progress of diagnosis and treatment system for knee dislocation (KD) based on the stage and classification of posteromedial structure and posterolateral corner injury, so as to provide guidance for clinical work. Methods The relevant literature on the classification, diagnosis and treatment was extensively reviewed. Results At present, the criterion of the stage and classification of KD mainly include classification based on the size of the injury energy, Kennedy classification, and the improved Schenck classification, but they are not perfect because of no stage and classification of multiple ligament injury and no standardized treatment of different injuries. Hua Xi Knee Dislocation and Multiple Ligament Injury (HX-KDMLI) has optimum plan for injury treatment of posteromedial structure and posterolateral corner injury in KD based on stage and classification. Conclusion At present, there is no unified opinion on stages and classifications of the posteromedial structure and posterolateral corner injury in KD as well as on diagnosis and treatment. HX-KDMLI has certain feasibility for the stage and classification of the posteromedial structure and posterolateral corner injury in KD, to a certain extent, it can be used as reference for the diagnosis and treatment of KD.

关键词: 膝关节脱位; 后内侧结构; 后外侧角; 分期分型; 诊疗体系

Key words: Knee dislocation; posteromedial structure; posterolateral corner; stage and classification; diagnosis and treatment system

引用本文: 黄华强, 李箭, 唐新. 膝关节脱位后内侧结构及后外侧角损伤分期分型及诊治体系. 中国修复重建外科杂志, 2017, 31(5): 614-619. doi: 10.7507/1002-1892.201611139 复制

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