改良LaPrade技术单期解剖后外侧角重建术,联合关节镜下胫骨钉原位后交叉韧带重建术。

IF 3.3 Q1 ORTHOPEDICS
N. Nizaj DNB(Ortho), MRCS (Glasgow) , Jimmy Joseph Meleppuram MS (Ortho), FAASM , Hamdi Nizar Ahamed MS (Ortho), FAASM , T. Ajayakumar D'Ortho, MS (Ortho) , Ayyappan V. Nair D'Ortho, DNB(Ortho) , Azad Sait D'Ortho, MS (Ortho) , Prince Shanavas Khan D'Ortho, MS (Ortho)
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引用次数: 0

摘要

膝关节后外侧角(PLC)是提供膝关节内翻和旋转稳定性的关键解剖结构。PLC损伤由于其复杂的性质,对骨科医生提出了巨大的挑战。PLC损伤很少单独发生,高达95%与韧带撕裂有关。III级损伤需要手术重建,临床定义为内翻应力下>0 mm外侧开口,刻度盘试验中>10°外旋,MRI结果支持。介绍了几种用于PLC改造的技术;然而,LaPrade描述的经典解剖重建仍然是金标准,传统上使用同种异体跟腱移植。在本视频技术中,我们描述了一种改良的LaPrade技术,使用腓长肌和腘绳肌腱自体移植物分别用于PLC和后交叉韧带(PCL)重建,用于胫骨钉原位治疗IIIb型胫骨开放性骨折。腓骨长肌腱被塑造成y形结构,必须至少250毫米长才能进行这项技术。移植物通道和固定顺序与LaPrade技术相反。该方法确保解剖固定、独立张紧和每个节段的安全固定,从而恢复膝关节的正常生物力学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Single stage anatomic posterolateral corner reconstruction with modified LaPrade technique, combined with arthroscopic posterior cruciate ligament reconstruction with tibia nail in situ—A current technique
The posterolateral corner (PLC) of the knee is a key anatomical structure which provides varus and rotational stability to the knee joint. Injuries to the PLC pose a great challenge for orthopedic surgeons due to their complex nature. PLC injuries rarely occur in isolation, with up to 95% being associated with ligament tears. Surgical reconstruction is indicated in Grade III injuries, defined clinically as >10 ​mm lateral opening on varus stress and >10° external rotation on the dial test, supported by MRI magnetic resonance imaging findings.
Several techniques have been described for PLC reconstruction; however, the classic anatomic reconstruction described by LaPrade remains the gold standard, traditionally performed using an Achilles tendon allograft. In this video technique, we describe a modified LaPrade technique using peroneus longus and hamstring tendon autografts for PLC and posterior cruciate ligament (PCL) reconstruction, respectively, in a patient having tibia nail in situ for Type IIIb open fracture shaft of tibia. The peroneus longus tendon is fashioned into a Y-shaped construct and must be at least 250 ​mm long to perform this technique. The graft passage and fixation sequence are the reverse of the LaPrade technique. This method ensures anatomic fixation, independent tensioning, and secure fixation of each segment, thereby restoring the normal biomechanics of the knee.
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
61
审稿时长
108 days
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