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目的 :设计、应用超高分子聚乙烯套栓闭合韧带固定术 ,提出临床使用价值。方法 :采用新型研制的超高分子聚乙烯套栓闭合韧带固定法 ,修复、重建 89例膝关节韧带损伤 ,其中重建前交叉韧带 (ACL) 74例 ,后交叉韧带 (PCL) 13例 ,外侧副韧带 2例。韧带重建术后第 2日由专科治疗师实施康复计划。结果 :89例患者均一次固定成功。 2例套栓、3例移植腱在骨隧道内牵拉受阻 ,套栓退出后清理骨隧道 ,重新牵拉套栓经骨隧道顺利通过 ;1例套栓在骨隧道内嵌顿 ,不能退出 ,镜下取出套栓 ,重新缝合移植、修复的韧带 ,闭合固定成功。本组病例平均随访 19个月 (6个月～ 4 9个月 ) ,7例关节内韧带重建术后较对侧稍松动 ,但较术前功能明显改善 ,2例膝部劳累后胀痛 ,3例关节屈曲受限 2 0度 ,其余病例关节稳定 ,关节功能正常。Lysholm关节功能评分 ,术前 5 6± 8,术后 89± 5 (P <0 .0 1)。结论 :超高分子聚乙烯套栓闭合韧带固定法 ,具有操作简便 ,安全可靠 ,无副作用 ,明显缩短手术时间等特点。尤其利于关节镜下膝关节韧带重建术等高新技术的普及
OBJECTIVE: To design and apply the ultra-high molecular polyethylene sheath bolt closure and ligament fixation and put forward the clinical value. Methods: 89 cases of knee ligament injury were repaired and reconstructed by using the newly developed ultra-high molecular polyethylene sheath bolt closure and ligament fixation. Among them, 74 cases were reconstruction of anterior cruciate ligament (ACL), 13 cases of posterior cruciate ligament (PCL) Ligament in 2 cases. On the second day after reconstruction of the ligament, the rehabilitation program was carried out by a specialist therapist. Results: All 89 patients were successfully fixed. 2 cases of cuffs and 3 cases of tendon grafts were blocked in the bone tunnel. After the cuffs were withdrawn, the bone tunnels were cleared and the cuffs were re-drawn through the tunnels. One of the cuffs was incarcerated in the tunnel and could not be withdrawn. Remove the lens under the microscope, re-sutured graft, ligament repair, closed and fixed successfully. The patients were followed up for an average of 19 months (range, 6 months to 49 months). Seven cases of intra-articular ligament reconstruction were slightly loosened compared with the contralateral side, but their function was improved significantly compared with that before operation. Two cases of knee pain, 3 cases of joint flexion limited 20 degrees, the remaining cases of joint stability, joint function is normal. Lysholm joint function score, preoperative 5 6 ± 8, postoperative 89 ± 5 (P <0. Conclusion: The ultra-high molecular polyethylene sheath bolt closure ligament fixation method has the advantages of simple operation, safe and reliable, no side effect and obvious shortening operation time. Especially conducive to arthroscopic knee ligament reconstruction and other high-tech universal