关节镜下治疗前叉止点撕脱性骨折

（优选）关节镜下治疗前叉止点撕脱(Tuo)性骨折第一页，共五十九页。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第二页，共五十九页。Fallinjuryandtrafficaccident——51％Sportsinjuries——Skiingandfootball--14%TheKnee，2008，15(3)：164-167．第三页，共五十九页。Associatedwithcapsuletear

of

meniscus

or

articularcapsule,sometimes

including

medialandlateralcollateralligamentinjuryorinjuryofarticularcartilageArthroscopy:TheJournalofArthroscopicandRelatedSurgery,2005,21(1):86-92.第四页，共五十九页。Relevant

anatomicalstructure第五页，共五十九页。Residentridge第六页，共五十九页。Residentridge第七页，共五十九页。Branchingridge第八页，共五十九页。Footprints第九页，共五十九页。Footprints第十页，共五十九页。第十一页，共五十九页。Theanteriormedialbundleistightinflexion

theposteriorlateralbundleistightinthestraightposition第十二页，共五十九页。12损伤(Shang)机制Youngpeople-kneeflexion,tibialinternalrotationAdults-hyperextensionofthekneeACLlimitsanteriordisplacement,hyperextension,andinternalrotation第十三页，共五十九页。DiagnosisInjury

history

of

hyperextensionofkneeBruise

and

hyphemaTheextensionwaslimitedAnterior

drawertestandLachmansignare

positiveX-ray

and

CT

are

conducivetounderstandingoffractureMRIishelpfultounderstandinjury

of

ACL,andothers

combinedinjury.第十四页，共五十九页。Anterior

drawertestandLachmansign第十五页，共五十九页。X-ray第十六页，共五十九页。CT第十七页，共五十九页。MRI第十八页，共五十九页。Meyers-McKeeverclassificationArthroscopy2005;21[1]:86-92第十九页，共五十九页。Howtoidentifyfreshoroldfracturesinimaging第二十页，共五十九页。TreatmentItypeConservativetreatment

to

keep

the

knee

in

a

functionalposition

for

6weeksⅡ

and

Ⅲ

types

Manipulation，iffail，selectedsurgeryⅣ

type

Surgery第二十一页，共五十九页。Reduction

Thedrawertestafterextension第二十二页，共五十九页。P-R-I-C–E

programProtectionRestIceCompressionElevate

第二十三页，共五十九页。It

usedtobethemostcommonlytreatmentprogramtoopenreductionandfixedwithwire第二十四页，共五十九页。AfailedcaseCase1第二十五页，共五十九页。Singletunnelfixationwithsteelwireandextrusionscrew第二十六页，共五十九页。Noextrusionnailwasfoundbeforeoperationimpinge第二十七页，共五十九页。Ifthefracturemassissmall,usingEthibondsuture第二十八页，共五十九页。OldfractureofavulsionfractureofACLCase2第二十九页，共五十九页。Woundfreshness第三十页，共五十九页。Tocleanandremovealldead,damagedtissuearoundofthefracturemass第三十一页，共五十九页。Tointroducethewirebyalumbarpunctureneedle第三十二页，共五十九页。TothreadthroughNo.5Ethibond,andfixfracturewith"8"tensionband第三十三页，共五十九页。Toinspectcarefully第三十四页，共五十九页。Thepatientswerefollowedupfor1monthaftersurgery第三十五页，共五十九页。Case3TousePDSiiasthethread第三十六页，共五十九页。TousePDSiiasthethread第三十七页，共五十九页。TousePDSiiasthethread第三十八页，共五十九页。Case4OldavulsionfractureofACL第三十九页，共五十九页。Withbonesclerosis,andACLstretchandtear第四十页，共五十九页。Theboneblockcannotberemovedwiththenucleuspulposusclampmicro-grindingdrilltodrill第四十一页，共五十九页。ToremovebonemasswithnucleuspulposusforcepsEnlargementofthecondylarfossa第四十二页，共五十九页。Thepicturewastakenafterreconstructionofanteriorcruciateligament第四十三页，共五十九页。PostoperativeX-ray第四十四页，共五十九页。followedupfor1monthaftersurgery第四十五页，共五十九页。Forabiggerfractureblock,hollowscrewisagoodchoice第四十六页，共五十九页。Lateralmeniscus(LM)isbeingpulledanddisplaced第四十七页，共五十九页。Ifthefractureofthetibialplateauiscombined,firstofall,thefractureshouldbefixed第四十八页，共五十九页。X-rayshowedACLavulsionfracturecombinedwithtibialplateaufractureCase4第四十九页，共五十九页。MRI第五十页，共五十九页。Tocheckthestabilityofkneejointbeforeoperation第五十一页，共五十九页。TocarefullyexaminethecollapseofthelateraltibialplateauToreduceandfixtibialplateaufractures第五十二页，共五十九页。ToremovethesynovialtissueofthefemoralcondyleArthroscopicimageofthereducefracture第五十三页，共五十九页。TocutthetransverseligamentofmeniscusThereductionofthefracturemassisblockedbythetransverseligamentofthemeniscus第五十四页，共五十九页。ToreducefractureTofixedfracturewithk-wiretemporarily第五十五页，共五十九页。To

drill

intosecondK-wireAguidepinisinserted第五十六页，共五十九页。To

screwintothehollowscrewTo

inspect

after

fixation第五十七页，共五十九页。