重建髌建的方法

Summary-概述

在不可修复的髌腱断裂的情况下，髌腱重建在技术上可能是一个困难和持久的过程。采用同种异体跟腱移植重建髌腱的另一种外科技术是利用胫骨结节固定骨栓。这项技术使用简单的仪器，对膝盖的创伤较小，可以使患者更容易康复。

[Summary: Patellar tendon reconstruction in the setting of a nonrepairable patellar tendon rupture can be a technically difficult and extensive procedure. An alternative surgical technique for patellar tendon reconstruction with Achilles tendon allograft utilizes tibial tubercle interference fixation for the bone plug. This technique uses simple instrumentation and is less traumatic to the knee which may allow an easier patient recovery.]

Surgical technique-手术技巧

文章详细描述了手术过程。

▲图1：可见髌韧带断裂，陈旧性瘢痕形成，髌腱组织无活力。

▲图2：清除陈旧性瘢痕和不可修复的组织。

▲图3：胫骨结节创建11mm骨隧道。

▲图4：同种异体跟腱组织通过锚钉固定于胫骨结节骨隧道中。

▲图5：跟腱修整至合适髌韧带长度。

▲图6：通过髌骨钻孔用缝线将跟腱与髌骨缝合起来。

▲图7：重建后最终效果。

Key surgical steps-关键技术步骤

Discussion-讨论

不可修复的髌腱断裂是一个难以处理的问题。这种外科技术为外科医生提供了另一种选择，对胫骨近端的创伤可能较小，技术要求也比前面描述的要低。这项技术使用前交叉韧带重建中使用的标准器械，操作简单。这种重建髌腱的方法是治疗这一外科难题的有用工具。

[Conclusions: Nonrepairable patellar tendon rupture is a difficult problem to manage. This surgical technique offers the surgeon another option that may be less traumatic to the proximal tibia, and less technically demanding than those previously described. This technique is simple to perform using standard instruments as used in anterior cruciate ligament reconstruction. This method of patellar tendon reconstruction is a useful tool when
treating this difficult surgical problem.