关节镜下治疗儿童交叉韧带损伤课件

1、关节镜下治疗儿童交叉韧带损伤课件Caine D, Maffulli N, Caine C. Epidemiology of injury in child and adolescent sports: injury rates, risk factors, and prevention. Clin Sports Med. 2008;27:19-50. 流行病学ACL损伤是活跃儿童最严重、发病率最高的运动相关性损伤之一，发病率在上升5-18岁高发，占膝关节损伤的31%女:男=2.8青春期前部分撕裂、止点撕脱青春期后完全撕裂1 K. G. Shea, R. Pfeiffer, H. W. Jo,

2、M. Curtin, and P. J. Apel, “Anterior cruciate ligament injury in pediatric and adolescent soccer players: an analysis of insurance data,” Journal of Pediatric Orthopaedics, vol. 24, no. 6, pp. 623628, 2004.2 J. S. Prince, T. Laor, and J. A. Bean, “MRI of anterior cruciate ligament injuries and assoc

3、iated findings in the pediatric knee: changes with skeletal maturation,” American Journal of Roentgenology, vol. 185, no. 3, pp. 756762, 2005.儿童的ACL损伤的特殊性骨骺给治疗带来很多障碍膝关节骨骺:下肢2/3长度骨骺闭合时间:男: 6-18 ，女: 14-16合并伤较少10岁以下很少有半月板和关节软骨的损伤早期OA的可能性小HAVARD MOKSNES, LARS ENGEBRETSEN,MAY ARNA RISBERG. Management of

4、Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals. journal of orthopaedic & sports physical therapy.2012 ,42 (3): 172-183.诊断困难儿童的ACL较成人松弛儿童的MRI检查特异性和敏感性下降自愈能力强治疗方案的特殊性Joshua L. Hudgens and Diane L. Dahm. Treatment of Anterior Cruciate Ligament Injury in Skeletally Immature Patie

5、ntJ.sHindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 932702, 6 pages doi:10.1155/2012/932702VSP. Vavken and M. M. Murray, “Treating anterior cruciate ligament tears in skeletally immature patients,” Arthroscopy, vol. 27, no. 5, pp. 704716, 2011.VS手术方法HAVARD

6、 MOKSNES, LARS ENGEBRETSEN,MAY ARNA RISBERG. Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals. journal of orthopaedic & sports physical therapy.2012 ,42 (3): 172-183.非解剖重建：骨-髌腱-骨重建非解剖重建：髂胫束重建非解剖重建：髂胫束重建非解剖重建：髂胫束重建如何进行儿童的解剖重建？解剖重建 内口解剖MRI-关节镜下所见，ACL实质部偏下方断裂。如此严重的损伤必定有合并伤！外侧半月板后角瓣状裂利用ACL瞄准器定位股骨隧道内口及外口通过瞄准器钻入导针利用ACL瞄准器定位胫骨隧道内口及外口。ACL内口比较重要。残根用缝合钩缝合，用PDS-保残电视透视避开骨骺线电视透视避开骨骺线透视证实后钻空心钻头。穿入钢丝准备引线