アブストラクト
| Title | 靱帯 (1) : 内側側副靱帯損傷の診断と治療 |
|---|---|
| Subtitle | 特集 : 膝窩部・膝内側部痛の診療 - すぐに役立つQ&A - |
| Authors | 高原康弘*1, 中島裕貴*2 |
| Authors (kana) | たかはらやすひろ |
| Organization | *1日本鋼管福山病院整形外科, 部長, *2産業医科大学若松病院 整形外科 |
| Journal | MB Orthopaedics |
| Volume | 35 |
| Number | 1 |
| Page | 53-60 |
| Year/Month | 2022 / 1 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」内側側副靱帯(medial collateral ligament:MCL)損傷は比較的頻度の高い損傷で, 膝への外反力が加わり受傷する. MCL損傷は基本的に保存療法でその予後は良好であるが, 膝関節における最も重要な支持機構であり, 不安定性が残った場合の影響は大きい. 手術適応については, その損傷程度の判定が重要でストレス撮影において膝30°屈曲位, 伸展位とも著明な外反不安定性があり, エンドポイントがない症例となる. 通常, 前十字靱帯損傷との合併においては, 基本的にMCL損に対して保存療法を行うが, grade 3の中に内側不安定性が残存する症例もあり, 修復術やsuture tapeを用いた補強術も考慮する. 交通外傷や転落などの高エネルギー外傷においては特に注意が必要となる. Grade 3のMCL損傷において, 関節内に損傷したMCLが反転して挟まっている症例や大きな裂離骨片を伴う症例, 脛骨側での完全な裂離損傷は絶対的な手術適応となる. 手術方法については, 新鮮損傷においては観血的または鏡視下にアンカーを用いた修復術を行うが, suture tapeを用いた補強術を追加しても良い. 陳旧例には自家腱を用いた再建術の適応となる. |
| Practice | 臨床医学：外科系 |
| Keywords | 内側側副靱帯損傷(MCL injury), ストレス撮影(stress X ray), スーチャーアンカー(suture anchor), 補強術(internal bracing) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
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残りの15件を表示する
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