摘要
目的 探讨CT对于确定交叉韧带断裂部位的价值。方法 对有膝关节外伤史、膝关节检查有可疑交叉韧带损伤者 ,分别摄双侧膝关节屈膝 90°前、后抽屉试验位X线侧位片。于X线片上 ,从股骨髁的中心点向胫骨平台前、后缘连线做垂线将后者分为前后两段 ,任何一段比健侧同段长 5mm以上则为阳性。即前段长者为前交叉韧带完全断裂 ,后段长者为后交叉韧带完全断裂。之后作膝关节部位的薄层CT扫描 (层厚、层距均为 1 5mm) ,观察胫骨上端前、后方有无撕脱性小骨块 ,以及股骨髁间窝处股骨外髁内侧或股骨内髁外侧有无撕脱性小骨块。结果 从 1994年 1月～ 1999年 11月按上述方法共诊断交叉韧带完全断裂者 18例。其中 ,前交叉韧带于胫骨止点处撕脱者 1例 ;后交叉韧带于胫骨止点处撕脱者 2例 ;前交叉韧带于股骨外侧髁起点处撕脱者 2例 ;后交叉韧带于股骨内侧髁起点处撕脱同时伴内侧副韧带股骨附着部撕脱性骨折 1例 ;1例膝关节脱位者伴腓骨小头撕脱性骨折及腓总神经损伤。其余病例自韧带实质部断裂。所有病例均经手术修复或重建 ,除 1例术前诊断为单纯前交叉韧带实质部完全断裂 ,而术中发现前交叉韧带实质部断裂约 90 %外 ,其余病例的术前诊断与术中所见均完全吻合。
Objective To study the value of computed tomography(CT) in location of cruciate ligmemts tear.Methods Lateral roentgenograms of bilateral knees,under the condition of anterior and posterior drawer tests,were taken if one patient had a history of knee joints trauma and was suspicious of suffering from cruciate ligaments injury after careful examination of both knees.On lateral roentgenograms a perpendicular line was made from the center of femoral condyle to the line linking the anterior and posterior borders of tibia platform.The latter was divided into anterior and posterior segments.Any segment longer than the same one on the healthy side more than five millimeters was judged as positive,if the anterior segment is longer,it means complete rupture of anterior cruciate ligamentand if the posterior segment is longer,it means complete rupture of posterior ligament.Then a thin layer CT(both layer thickness and distance are 1 5 mm)was taken.For observing any small avulsed bone anterior or posterior the upper end of tibia,or medial side of lateral femoral condyle,or lateral side of medial femoral condyle in the intercondylar notch.Results From January 1994 to November 1999 eighteen patients were diagnosed as complete rupture of cruciate ligaments.Among them,anterior cruciate ligament avulsed from its attachment on tibia in one case;posterior cruciate ligament avulsed from its attachment on tibia in two cases;anterior cruciate ligament avulsed from its attachment on lateral condyle of femur in two cases;posterior cruciate ligament avulsed from its attachment on medial condyle of femur accompanied by medial collateral ligament avulsed from its attachment on femur in one case;dislocation of knee joint accompanied by avulsed fracture of caput fibulae and injury of common peroneal nerve in one case.The other cases had rupture of ligaments in their ligamentous parenchyma.Surgical repair or reconstruction were carried out in all cases.Pre and post operative diagnosed coincided in all cases except one,who was diagnosed as complete rupture of anterior cruciate ligament in parenchyma before operation,while disruption of 90% parenchyma was found during operation.Conclusion It can be concluded that CT has important values in locating disruption of cruciate ligaments.
出处
《骨与关节损伤杂志》
2001年第3期170-171,共2页
The Journal of Bone and Joint Injury
关键词
膝关节交叉韧带断裂
CT
诊断
Diagnosis
Computed tomography
Anterior cruciate ligament
Posterior cruciate ligament
