关节镜下治疗前叉止点撕脱性骨折 ppt课件
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placement and removal of cannulated screw for fixation ➢ 2008——Jinzhong Zhao reported arthroscopic Figure-of-8 suture fixation technique
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2
epidemiology
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13
损伤机制
ACL limits anterior displacement, hyperextension, and internal rotation
1
2
Adults - hyperextension of the knee
Young people - knee flexion,
tibial internal rotation
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14
Diagnosis
➢ Injury history of hyperextension of knee
➢ Bruise and hyphema
➢ The extension was limited
➢ Anterior drawer test and Lachman sign are positive
Avulsion Fracture of Anterior Cruciate Ligament
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1
History
➢ 1875—— Poncet ➢ 1970——Avulsion fracture of the ACL was
classified by Meyers MH ➢ 1996——Veselko M performed arthroscopic
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8
Branching ridge
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9
Footprints
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10
Footprints
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11
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12
➢ The anterior medial bundle is tight in flexion the posterior lateral bundle is tight in the straight position
➢ X-ray and CT are conducive to understanding of fracture
✓ MRI is helpful to understand injury of ACL, and
others combined injury.
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15
Anterior drawer test and Lachman sign
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21
Treatment
➢ I type --- Conservative treatment to keep the knee in a functional position for 6 weeks
➢ Ⅱ and Ⅲ types --- Manipulation，if fail， selected surgery
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3
➢ Fall injury and traffic accident——51％ ➢ Sports injuries——Skiing and football--14%
The Knee，2008，15(3)：164-167．
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4
➢ Associated with capsule tear of meniscus or articular capsule, sometimes including medial and lateral collateral ligament injury or injury of articular cartilage
➢ Morbidity——3/100000
✓ 14％ of ACL injury
➢ Distribution of age
➢ children——8～14 years old ➢ old women——over 40 years old
Accid E-merg Nurs，2004，12(3)：1 73-1 75． International Journal of Pediatrics, 2012, Article ID 932702, 6 pages
➢ Ⅳ type --- Surgery
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22
Reduction
➢The drawer test after extension
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23
P - R - I - C – E program
➢ Protection ➢ Rest ➢ Ice ➢ Compression ➢ Elevate
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16
X-ray
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17
CT
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18
MRI
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19
Meyers-McKeever classification
Arthroscopy 2005;21[1]:86-92
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20
➢How to identify fresh or old fractures in imaging
Arthroscopy: The Journal of Arthroscopic and Related Surgery, 2005,21(1):86-92.
编辑版ppt
5
Relevant anatomical structure
编辑版ppt6ResidFra biblioteknt ridge
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7
Resident ridge
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27
No extrusion nail was found before operation
➢impinge
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28
If the fracture mass is small, using Ethibond suture
编辑版ppt
24
➢It used to be the most commonly treatment program to open reduction and fixed with wire
编辑版ppt
25
Case 1
➢A failed case
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26
Single tunnel fixation with steel wire and extrusion screw
编辑版ppt
2
epidemiology
编辑版ppt
13
损伤机制
ACL limits anterior displacement, hyperextension, and internal rotation
1
2
Adults - hyperextension of the knee
Young people - knee flexion,
tibial internal rotation
编辑版ppt
14
Diagnosis
➢ Injury history of hyperextension of knee
➢ Bruise and hyphema
➢ The extension was limited
➢ Anterior drawer test and Lachman sign are positive
Avulsion Fracture of Anterior Cruciate Ligament
编辑版ppt
1
History
➢ 1875—— Poncet ➢ 1970——Avulsion fracture of the ACL was
classified by Meyers MH ➢ 1996——Veselko M performed arthroscopic
编辑版ppt
8
Branching ridge
编辑版ppt
9
Footprints
编辑版ppt
10
Footprints
编辑版ppt
11
编辑版ppt
12
➢ The anterior medial bundle is tight in flexion the posterior lateral bundle is tight in the straight position
➢ X-ray and CT are conducive to understanding of fracture
✓ MRI is helpful to understand injury of ACL, and
others combined injury.
编辑版ppt
15
Anterior drawer test and Lachman sign
编辑版ppt
21
Treatment
➢ I type --- Conservative treatment to keep the knee in a functional position for 6 weeks
➢ Ⅱ and Ⅲ types --- Manipulation，if fail， selected surgery
编辑版ppt
3
➢ Fall injury and traffic accident——51％ ➢ Sports injuries——Skiing and football--14%
The Knee，2008，15(3)：164-167．
编辑版ppt
4
➢ Associated with capsule tear of meniscus or articular capsule, sometimes including medial and lateral collateral ligament injury or injury of articular cartilage
➢ Morbidity——3/100000
✓ 14％ of ACL injury
➢ Distribution of age
➢ children——8～14 years old ➢ old women——over 40 years old
Accid E-merg Nurs，2004，12(3)：1 73-1 75． International Journal of Pediatrics, 2012, Article ID 932702, 6 pages
➢ Ⅳ type --- Surgery
编辑版ppt
22
Reduction
➢The drawer test after extension
编辑版ppt
23
P - R - I - C – E program
➢ Protection ➢ Rest ➢ Ice ➢ Compression ➢ Elevate
编辑版ppt
16
X-ray
编辑版ppt
17
CT
编辑版ppt
18
MRI
编辑版ppt
19
Meyers-McKeever classification
Arthroscopy 2005;21[1]:86-92
编辑版ppt
20
➢How to identify fresh or old fractures in imaging
Arthroscopy: The Journal of Arthroscopic and Related Surgery, 2005,21(1):86-92.
编辑版ppt
5
Relevant anatomical structure
编辑版ppt6ResidFra biblioteknt ridge
编辑版ppt
7
Resident ridge
编辑版ppt
27
No extrusion nail was found before operation
➢impinge
编辑版ppt
28
If the fracture mass is small, using Ethibond suture
编辑版ppt
24
➢It used to be the most commonly treatment program to open reduction and fixed with wire
编辑版ppt
25
Case 1
➢A failed case
编辑版ppt
26
Single tunnel fixation with steel wire and extrusion screw