■本病例报告的目的是介绍一例慢性颈椎韧带撕裂和不稳定的病例,与通常的倒置机制相反,这是由于异常的工作伤害具有外翻/内旋机制。使用同种异体移植物重建韧带,手术后长达30个月,效果满意。开发了一种新的磁共振成像方案(MRI),以更好地评估颈椎韧带/移植物。
■在诊断脚扭伤时,应始终寻求特定的韧带损伤。在这种情况下,体格检查在颈椎韧带位置产生压痛,并将其与斜柱间应力测试相关联,该测试重现了疼痛,并伴有忧虑和严重不稳定,从而支持了诊断。回顾性地将解剖学知识应用于距骨和跟骨颈韧带插入点处骨髓水肿的早期MRI发现对于确认诊断很重要。为了更好地评价同种异体颈椎韧带肌腱重建,开发了一种新的体积MRI序列,该序列可能有助于在将来的病例中诊断颈椎韧带损伤。在30个月的随访中,颈椎韧带的解剖重建提供了令人满意的临床和影像学结果。证据级别:V.
UNASSIGNED: The aim of this case report is to present a case of chronic cervical ligament tear and instability, which occurred by an unusual work injury with an eversion/hyper-pronation mechanism in contrast to the usual mechanism of inversion. The ligament was reconstructed using an allograft with satisfactory results up to 30 months after surgery. A new magnetic resonance imaging protocol (MRI) was developed to better evaluate the cervical ligament/graft.
UNASSIGNED: In diagnosis of foot sprains, a specific ligament injury should always be sought. In this case, physical examination producing tenderness at the location of the cervical ligament and correlating this with an oblique intercolumn stress test that reproduced pain with apprehension and gross instability supported the diagnosis. Retrospectively applying anatomic knowledge to the earlier MRI findings of bone marrow edema at the insertion points of the cervical ligament on the talus and calcaneus was important in confirming the diagnosis. To better evaluate the cervical ligament allograft tendon reconstruction, a novel volumetric MRI sequence was developed which may prove helpful to also diagnose cervical ligament injuries in future cases. Anatomic reconstruction of the cervical ligament provided satisfactory clinical and radiographic results at 30-month follow-up.Level of Evidence: V.