• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Physeal Disruption During ACL Reconstruction in Skeletally Immature Patients
【24h】

Physeal Disruption During ACL Reconstruction in Skeletally Immature Patients

机译：骨骼不成熟患者在ACL重建过程中的肢体干扰

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives: The purpose of this study was to radiographically assess differences in distal femoral physeal disruption between transtibial and independent femoral tunnel drilling techniques following ACL reconstruction in skeletally immature patients. Methods: A retrospective, matched comparative cohort study was performed of skeletally immature patients who underwent transphyseal ACL reconstruction between January 1, 2008 and March 31, 2011. All skeletally immature patients between ten and fifteen years old who underwent independent femoral tunnel drilling and had adequate baseline and post-operative radiographs were analyzed. These patients were matched with a transtibial technique cohort based on age and sex. Demographic characteristics and peri-operative metrics were collected. Radiographic measurements were recorded from pre-operative MRI and post-operative plain radiographs. Results: Twenty patients were analyzed. Between groups, there were significant differences between independent tunnel drilling and transtibial tunnel drilling in the estimated area of physeal disruption (1.64 cm2 vs. 0.74 cm2, P<0.001), femoral (32.1o vs. 72.8o, P<0.001) and tibial (50.1o vs. 60.5o, P=0.003) tunnel angles, medial/lateral location of the femoral tunnel (24.2 mm vs. 36.1 mm from lateral cortex, P=0.001), and distance from the lateral aspect of the distal femoral physis and the femoral tunnel exit (4.7 mm vs. 26.7 mm from the perichondrial ring, P<0.001), respectively. All patients who underwent femoral tunnel drilling at an angle of less than 25o from the transverse axis experienced a greater than 6% disruption of physeal area. There was a significant inverse correlation between femoral tunnel angle and estimated area of femoral physeal involvement (r=-0.8255, P=0.003). Conclusion: With femoral tunnel drilling techniques that create more oblique tunnels, the area of distal femoral physeal damage is larger, more eccentric and closer to the perichondrial ring. Since most studies noting the safety of transphyseal ACL reconstruction have utilized a vertical femoral tunnel, surgeons should be aware that if an independent femoral tunnel drilling technique is utilized during transphyseal ACL reconstruction, the physis is at greater risk when drilling at more horizontal angles. Angles greater than 25o from the transverse axis may safely create <6% physeal area damage.
机译：目的：本研究的目的是对骨骼发育不全的患者进行ACL重建后，通过影像学评估经胫骨和独立股骨隧道钻技术之间的远端股骨干破坏的差异。方法：对2008年1月1日至2011年3月31日接受经trans骨ACL重建的骨骼未成熟患者进行回顾性匹配队列研究。所有年龄在10至15岁之间的骨骼未成熟患者均接受独立的股骨隧道钻孔术并具有足够的分析基线和术后X线片。这些患者根据年龄和性别进行了跨胫骨技术队列研究。收集人口统计学特征和围手术期指标。术前MRI和术后X线片记录放射线测量值。结果：分析20例患者。在各组之间，在估计的骨干破坏区域（1.64 cm2对0.74 cm2，P <0.001），股骨（32.1o对72.8o，P <0.001）和胫骨区域，独立隧道钻和经胫骨隧道钻之间存在显着差异。 （50.1o vs. 60.5o，P = 0.003）隧道角度，股骨隧道的内侧/外侧位置（距外侧皮层的距离为24.2 mm与36.1 mm，P = 0.001）以及距股骨远端物理外侧的距离股骨隧道出口（距软骨膜环的距离分别为4.7 mm和26.7 mm，P <0.001）。所有与横轴成小于25o角度进行股骨隧道钻孔的患者的骨s面积破坏均大于6％。股骨隧道角度与估计的股骨干累及面积之间呈显着负相关（r = -0.8255，P = 0.003）。结论：利用股骨隧道钻孔技术可产生更多的斜形隧道，股骨远端植骨损伤的区域更大，更偏心并且更靠近软骨膜环。由于大多数研究了经phy骨ACL重建安全性的研究均使用了垂直的股骨隧道，因此外科医生应意识到，如果在经phy骨ACL重建过程中采用独立的股骨隧道钻孔技术，则在更大的水平角度进行钻孔时，其物理风险更大。与横轴的夹角大于25o可能会造成小于6％的骨膜面积损害。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号