中文摘要：

目的探讨完全经骺板自体半腱肌、股薄肌肌腱重建前十字韧带治疗青少年前十字韧带损伤的临床疗效。方法2004年5月至2012年3月青少年前十字韧带损伤患者10例，男5例，女5例；年龄13-14岁，平均（13．4±1．2）岁。病程1-12个月，平均（5．3±2．3）个月。关节镜检查提示前十字韧带断裂，合并内侧半月板损伤1例、外侧半月板损伤1例、内外侧半月板同时损伤3例。行关节镜下前十字韧带重建术，术中完全经骺板建立骨隧道，股骨侧用Endobutton悬吊固定，胫骨侧用可吸收螺钉固定。术后佩带侧方带钢条的护膝3个月。末次随访时行站立位下肢全长x线检查及前抽屉试验、Lachman试验，评估KT-2000关节松弛度，以2000国际膝关节评分委员会（Intemational Knee Documentation Committee, IKDC）膝关节主观评价问卷、Lysholm膝关节评分量表和Tegner膝关节运动评分进行膝关节功能评估。结果10例均获得随访，随访时间3-12年，平均（6．7±3.3）年。末次随访时2000 IKDC膝关节主观评分由术前（75．1±5．1）分提高至（93．3±3．0）分，Lysholm膝关节评分从术前（66．1±8．2）分提高至（94．8±3．6）分，Tegner膝关节运动评分从术前（4．4±0．8）分提高至（8．5±0．7）分，与术前比较差异均有统计学意义。3例患者前抽屉试验和Lachman试验弱阳性，其余为阴性。关节屈伸活动度平均为140°，与健侧相比膝关节活动受限均少于5°。KT-2000侧侧差值平均为（1．5±0.7）mm，其中3例〉2mm。股骨远端外侧角平均为87．4°±0．6°，胫骨近端外侧角平均为88．3°±0．7°。站立位下肢全长X线片示骺板未发生阻滞现象，双下肢未出现成角畸形及不等长。10例均未出现韧带再损伤，3例术后因半月板损伤而再次行关节镜手术。结论对骨骺未闭合的青少年前十字韧带损伤，采用完全经骺板自体半腱肌、股薄肌肌

英文摘要：

Objective To evaluate the clinical outcomes after transphyseal anterior cruciate ligament （ACL） reconstruction with hamstring autograft in skeletally immature patients. Methods Ten skeletally immature pubescent patients （10 knees） with a mean age of 13.4 years underwent transphyseal ACL reconstruction with hamstring autograft between May 2004 and March 2012. There were 5 males and 5 females. The average duration from injury to surgery was 5.3 months （range 1-12 months）. Arthroscopy confirmed ACL rupture in ten knees. Concurrent meniscal surgery was performed in 5 knees. The surgery was conducted via arthroscopically assisted transphyseal reconstruction of the ACL with use of an autogenous quadrupled hamstring tendon graft and fixation devices that do not cross the physes. A protective knee brace was used for 3 months postoperatively with motion limits for the first 2 weeks. The follow-up duration was 6.7 years （range 3-12 years）, with evaluation for the following outcomes： physical examination, namely KT-2000 measurements and functional outcome instruments （the International Knee Documentation Committee subjective knee form, the Lysholm scoring, and the Tegner knee activity scale）. Radiographs were performed for asymmetrical physeal closure, growth arrest lines and leg-length measurements. Results At the latest follow-up, the mean 2000 IKDC score improved from preoperative 75.1±5.1 to 93.3±3.0, the mean Lysholm score from preoperative 66.1±8.2 to 94.8±3.6 and the mean Tegner score from 4.4±0.8 to 8.5±0.7. All these outcomes had statistically significant difference. Lachman and pivot-shift testing were weekly positive in 3 knees and negative in 7 knees. The mean range of motion of the knee was 140°. Compared with the eontralateral knee, no restriction in knee range of motion of 5° or greater was observed in any patient. All patients had normal range of motion. The mean KT-2000 manual maximum side-to-side difference was 1.5±0.7 mm, while that in 3 patients was greater than 2 mm but sm