關(guān)節(jié)鏡下治療前叉止點(diǎn)撕脫性骨折

History1875——Poncet1970——AvulsionfractureoftheACLwasclassifiedby

MeyersMH1996——VeselkoMperformed

arthroscopicplacementandremovalofcannulatedscrewforfixation2008——JinzhongZhaoreported

arthroscopicFigure-of-8suturefixationtechnique當(dāng)前1頁，總共60頁。Morbidity——3/10000014％of

ACL

injuryDistribution

of

age

children——8～14

years

old

old

women——over

40

years

oldAccidE-mergNurs，2004，12(3)：173-175．InternationalJournalofPediatrics,2012,ArticleID932702,6pages

epidemiology當(dāng)前2頁，總共60頁。Fallinjuryandtrafficaccident——51％Sportsinjuries——Skiingandfootball--14%TheKnee，2008，15(3)：164-167．當(dāng)前3頁，總共60頁。Associatedwithcapsuletear

of

meniscus

or

articularcapsule,sometimes

including

medialandlateralcollateralligamentinjuryorinjuryofarticularcartilageArthroscopy:TheJournalofArthroscopicandRelatedSurgery,2005,21(1):86-92.當(dāng)前4頁，總共60頁。Relevant

anatomicalstructure當(dāng)前5頁，總共60頁。Residentridge當(dāng)前6頁，總共60頁。Residentridge當(dāng)前7頁，總共60頁。Branchingridge當(dāng)前8頁，總共60頁。Footprints當(dāng)前9頁，總共60頁。Footprints當(dāng)前10頁，總共60頁。當(dāng)前11頁，總共60頁。Theanteriormedialbundleistightinflexion

theposteriorlateralbundleistightinthestraightposition當(dāng)前12頁，總共60頁。12損傷機(jī)制Youngpeople-kneeflexion,tibialinternalrotationAdults-hyperextensionofthekneeACLlimitsanteriordisplacement,hyperextension,andinternalrotation當(dāng)前13頁，總共60頁。DiagnosisInjury

history

of

hyperextensionofkneeBruise

and

hyphemaTheextensionwaslimitedAnterior

drawertestandLachmansignare

positiveX-ray

and

CT

are

conducivetounderstandingoffractureMRIishelpfultounderstandinjury

of

ACL,andothers

combinedinjury.當(dāng)前14頁，總共60頁。Anterior

drawertestandLachmansign當(dāng)前15頁，總共60頁。X-ray當(dāng)前16頁，總共60頁。CT當(dāng)前17頁，總共60頁。MRI當(dāng)前18頁，總共60頁。Meyers-McKeeverclassificationArthroscopy2005;21[1]:86-92當(dāng)前19頁，總共60頁。Howtoidentifyfreshoroldfracturesinimaging當(dāng)前20頁，總共60頁。TreatmentItypeConservativetreatment

to

keep

the

knee

in

a

functionalposition

for

6weeksⅡ

and

Ⅲ

types

Manipulation，iffail，selectedsurgeryⅣ

type

Surgery當(dāng)前21頁，總共60頁。Reduction

Thedrawertestafterextension當(dāng)前22頁，總共60頁。P-R-I-C–E

programProtectionRestIceCompressionElevate

當(dāng)前23頁，總共60頁。It

usedtobethemostcommonlytreatmentprogramtoopenreductionandfixedwithwire當(dāng)前24頁，總共60頁。AfailedcaseCase1當(dāng)前25頁，總共60頁。Singletunnelfixationwithsteelwireandextrusionscrew當(dāng)前26頁，總共60頁。Noextrusionnailwasfoundbeforeoperationimpinge當(dāng)前27頁，總共60頁。Ifthefracturemassissmall,usingEthibondsuture當(dāng)前28頁，總共60頁。OldfractureofavulsionfractureofACLCase2當(dāng)前29頁，總共60頁。Woundfreshness當(dāng)前30頁，總共60頁。Tocleanandremovealldead,damagedtissuearoundofthefracturemass當(dāng)前31頁，總共60頁。Tointroducethewirebyalumbarpunctureneedle當(dāng)前32頁，總共60頁。TothreadthroughNo.5Ethibond,andfixfracturewith"8"tensionband當(dāng)前33頁，總共60頁。Toinspectcarefully當(dāng)前34頁，總共60頁。Thepatientswerefollowedupfor1monthaftersurgery當(dāng)前35頁，總共60頁。Case3TousePDSiiasthethread當(dāng)前36頁，總共60頁。TousePDSiiasthethread當(dāng)前37頁，總共60頁。TousePDSiiasthethread當(dāng)前38頁，總共60頁。Case4OldavulsionfractureofACL當(dāng)前39頁，總共60頁。Withbonesclerosis,andACLstretchandtear當(dāng)前40頁，總共60頁。Theboneblockcannotberemovedwiththenucleuspulposusclampmicro-grindingdrilltodrill當(dāng)前41頁，總共60頁。ToremovebonemasswithnucleuspulposusforcepsEnlargementofthecondylarfossa當(dāng)前42頁，總共60頁。Thepicturewastakenafterreconstructionofanteriorcruciateligament當(dāng)前43頁，總共60頁。PostoperativeX-ray當(dāng)前44頁，總共60頁。followedupfor1monthaftersurgery當(dāng)前45頁，總共60頁。Forabiggerfractureblock,hollowscrewisagoodchoice當(dāng)前46頁，總共60頁。Lateralmeniscus(LM)isbeingpulledanddisplaced當(dāng)前47頁，總共60頁。Ifthefractureofthetibialplateauiscombined,firstofall,thefractureshouldbefixed當(dāng)前48頁，總共60頁。X-rayshowedACLavulsionfracturecombinedwithtibialplateaufractureCase4當(dāng)前49頁，總共60頁。MRI當(dāng)前50頁，總共60頁。Tocheckthestabilityofkneejointbeforeoperation當(dāng)前51頁，總共60頁。TocarefullyexaminethecollapseofthelateraltibialplateauToreduceandfixtibialplateaufractures當(dāng)前52頁，總共60頁。ToremovethesynovialtissueofthefemoralcondyleArthroscopicimageofthereducefracture當(dāng)前53頁，總共60頁。TocutthetransverseligamentofmeniscusThereductionofthefracturemassisblockedbythetransverseligamentofthemeniscus當(dāng)前54頁，總共60頁。ToreducefractureTofixedfracturewithk-wiretemporarily當(dāng)前55頁，總共60頁。To

drill

intosecondK-wireAguidepinisinserted當(dāng)前56頁，總共60頁。To

screwintothehollowscrewTo

inspect

after

fixation當(dāng)前57頁，總共60頁。PostoperativeX-ray當(dāng)前58頁