【摘要】 目的探讨关节镜在下肢骨折中的应用价值。方法自１９９４年７月～１９９６年６月，共收治１０６２例、１１１９个股骨或胫骨骨折。其中股骨骨折４９５个，胫骨骨折６２４个。１７６例膝关节有症状且具有不稳定现象者予以关节镜手术。结果平均随访（２５．３±１０．７）个月。１３６例（１２．８％）有十字韧带损伤。其中前十字韧带损伤１０１例（７４．３％），后十字韧带损伤３５例（２５．７％）。自附着处撕裂及部分撕裂多于间质撕裂及完全撕裂，半月状软骨在前十字韧带损伤者为４２．６％，在后十字韧带损伤者为６０％。但半月状软骨关节囊韧带破裂多于半月状软骨本体损伤，旋转性不稳定多于单纯不稳定。骨软骨骨折亦常见。十字韧带损伤需手术治疗者占３３．８％。行手术治疗者Ｌｙｓｈｏｌｍ评分为８４，非手术治疗者为７９。膝活动度：弯曲（１２９．１±１０．４）°，伸直（２．１±１）°。结论在股骨或胫骨骨折且膝关节有症状或具有不稳定现象者行关节镜手术，疗效显著。更多还原

【Abstract】 Aim To explore the effect of arthroscope on lower limb fractures. Methods From July 1994 to June 1996, 1062 patients with femoral or tibial fractures (495 femoral fractures, 642 tibial fractures) in the same hospital were reviewed. Among them, 176 patients who have shown injury symptoms of the knee and shown instability in physical examination were included in the arthroscopic evaluation. Results Followed up for (25.3±10.7) months, 136 knees (12.8%) were found to have cruciate ligament lesions. In which, anterior cruciate ligament (ACL) lesions were in 101 knees (74.3%) and posterior cruciate ligament (PCL) lesions in 35 knees (25.7%). Avulsion from ligament attachment and partial tear were more than interstitial tear and complete tear. Meniscus lesions occurred in 42.6% of ACL group and 60% of PCL group. But meniscocapsular lesions were more than meniscus rupture itself. Rotatory instabilities (89.1% in ACL group and 77.1% in PCL group) were more than single plane instabilities, which reflect the nature of high energy trauma. Osteochondral fractures and pathologic medical plica were common (8.9% and 16.8 in ACL group, 20% and 25.7% in PCL group). Operative treatments were needed in 33.8% of knees (35.6% of ACL group and 28.6% of PCL group). Lysholm score was 84 in the operative group and 79 in the nonoperative group. The range of motion was (129.1±10.4)° in flexion, and (2.1±1)° in extension. Conclusion Arthroscopic evaluation is valuable in symptomatic knee after femoral or tibial diaphyseal fracture.更多还原