Early repair of iliotibial band reinforcement for rupture of anterior cruciate ligament

Early repair of anterior cruciate ligament rupture for the treatment of knee cruciate ligament injury. Knee ligament rupture is one of the most common serious injuries in the knee joint. The cruciate ligament can be a simple injury, but often accompanied by other ligament injuries, the most common is the injury of the collateral ligament. Early correct repairs are generally satisfactory. Reconstruction of the advanced cruciate ligament injury, due to the patient's multiple rotation instability, the reconstructed ligament can not reach the normal anatomical state, and gradually become slack after surgery, the effect is not satisfactory. Treatment of diseases: knee ligament injury knee lateral ligament injury Indication Early repair of anterior cruciate ligament rupture tendon reinforcement is applicable to: 1. The anterior cruciate ligament stump is in a tear-like tear; 2. The anterior medial side of the knee is unstable. Contraindications Anterior cruciate ligament injury and lateral instability of the knee exist simultaneously. Surgical procedure 1. Incision lateral longitudinal incision of the knee, from the junction of the lower third of the femur to the lower knee 5cm. 2. According to the early repair method of anterior cruciate ligament rupture, suture the anterior cruciate ligament stump. 3. bundle strengthening technique: reveal the iliotibial bundle, and cut 1 free strip of 14 to 20 cm in length and 3.5 to 4 cm in width from the front 2/3 of the bundle, and retain the distal end of the Getdy nodule at the distal humerus. The free strip is about 2 cm wide at the distal point, the proximal end is widened by 5-6 cm, and the left 1/3 of the bundle is not separated, and the proximal end of the rolled strip is intermittently sutured into a tubular shape. The long strip vascular clamp was used to clamp the free strip through the deep soft tissue tunnel of the lateral collateral ligament, and the suture of the ligament femur was firmly sutured and fixed on the periosteum. At this time, the knee should be kept at the external rotation of the humerus at 90° flexion. The periosteum was cut over the distal distal end of the femoral shaft and picked up to identify the femoral condyle. The periosteum is peeled off to the back of the intercondylar recess. At this time, the knee flexion position is operated to relax the iliac vessels to avoid damage. Using the osteotome along the site where the tendon is passed, make a shallow bone groove of 1 to 1.5 cm long, pass the posterior capsule to the posterior intercondylar notch, and start from the posterior edge of the lateral collateral ligament. A subperiosteal passage is made behind, which passes through the tendon and extends to the top of the femoral condyle. The knee flexed 90° and dislocated outside the humerus to find the entry point of the joint capsule after the iliac band. The curved vascular clamp is used to extend the anterior and posterior joints through the anterior and posterior interphalangeal fossa, and the anterior capsule is enlarged through the rupture of the joint capsule. The tendon bundle that penetrates the joint is sutured to the inside of the repaired anterior cruciate ligament. A tunnel was made 4 cm below the humeral ankle line, obliquely upward, and entered the joint at the edge of the articular cartilage on the medial plateau of the tibia and in front of the anterior intercondylar bulge. The tendon bundle was pulled through the tunnel to the front of the humerus and sutured with silk thread.

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