关节镜下治疗前叉止点撕脱性骨折-ppt课件.ppt

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1、AvulsionFractureofAnteriorCruciateLigament1History1875——Poncet1970——AvulsionfractureoftheACLwasclassifiedbyMeyersMH1996——VeselkoMperformedarthroscopicplacementandremovalofcannulatedscrewforfixation2008——JinzhongZhaoreportedarthroscopicFigure-of-8suturefixationtechnique2Morbidity

2、——3/10000014％ofACLinjuryDistributionofagechildren——8～14yearsoldoldwomen——over40yearsoldAccidE-mergNurs，2004，12(3)：173-175．InternationalJournalofPediatrics,2012,ArticleID932702,6pagesepidemiology3Fallinjuryandtrafficaccident——51％Sportsinjuries——Skiingandfootball--14%TheKnee，2008，

3、15(3)：164-167．4Associatedwithcapsuletearofmeniscusorarticularcapsule,sometimesincludingmedialandlateralcollateralligamentinjuryorinjuryofarticularcartilageArthroscopy:TheJournalofArthroscopicandRelatedSurgery,2005,21(1):86-92.5Relevantanatomicalstructure6Residentridge7Residentri

4、dge8Branchingridge9Footprints10Footprints1112Theanteriormedialbundleistightinflexiontheposteriorlateralbundleistightinthestraightposition1312损伤机制Youngpeople-kneeflexion,tibialinternalrotationAdults-hyperextensionofthekneeACLlimitsanteriordisplacement,hyperextension,andinternalr

5、otation14DiagnosisInjuryhistoryofhyperextensionofkneeBruiseandhyphemaTheextensionwaslimitedAnteriordrawertestandLachmansignarepositiveX-rayandCTareconducivetounderstandingoffractureMRIishelpfultounderstandinjuryofACL,andotherscombinedinjury.15AnteriordrawertestandLachmansign16X-

6、ray17CT18MRI19Meyers-McKeeverclassificationArthroscopy2005;21[1]:86-9220Howtoidentifyfreshoroldfracturesinimaging21TreatmentItype---Conservativetreatmenttokeepthekneeinafunctionalpositionfor6weeksⅡandⅢtypes---Manipulation，iffail，selectedsurgeryⅣtype---Surgery22ReductionThedrawer

7、testafterextension23P-R-I-C–EprogramProtectionRestIceCompressionElevate24Itusedtobethemostcommonlytreatmentprogramtoopenreductionandfixedwithwire25AfailedcaseCase126Singletunnelfixationwithsteelwireandextrusionscrew27Noextrusionnailwasfoundbeforeoperationimpinge28Ifthefracturema

8、ssissmall,usingEthibondsuture29Oldfractureofavu