小结
定义
内侧副韧带 (MCL) 是膝关节内侧的支撑结构。 [Figure caption and citation for the preceding image starts]: 内侧副韧带（右侧膝关节）由医学博士 Sanjeev Bhatia 创建；经许可后使用 [Citation ends].
其首要功能是限制胫骨相对于股骨的外翻（由中线向外扭转）和外旋。内侧副韧带损伤的机制通常是突然施加于膝关节的外翻作用力和/或外旋作用力过大。内侧副韧带损伤的严重程度范围可从少量韧带纤维撕裂至韧带的完全离断。
病史和体格检查
关键诊断因素
- 存在的危险因素
- 由于过度或反复的内侧副韧带外翻负荷导致的损伤
- 膝关节内侧痛
- 关节渗出
- 触痛
- 外翻应力松弛试验
其他诊断因素
- 瘀斑
- 损伤时可听见爆裂声或撕裂感
- 行走困难
- 膝关节不稳定症状
- 膝关节机械症状
- 膝关节变形
- 前抽屉试验阳性
- 后抽屉试验阳性
- Lachman 试验阳性
- 轴移试验阳性
- 关节线压痛
- 慢性疼痛
危险因素
- 参与涉及膝关节外翻应力的活动
- 年龄为 20 至 35 岁
- 年龄为 55 至 70 岁
- 膝关节的内侧肌肉薄弱
诊断性检查
首要检查
- 膝关节 X 线平片
- 膝关节应力位 X 线平片
需考虑的检查
- 膝关节部位 MRI
新兴检查
- 诊断性超声检查
治疗流程
单纯性 I 级损伤
单纯性 II 级损伤
单纯性 III 级损伤
内侧副韧带 + 前交叉韧带 (ACL) 合并损伤
内侧副韧带 + 非前交叉韧带 (ACL) 合并损伤
≥3 个月后高度外翻松弛持续
撰稿人
作者
Sanjeev Bhatia, MD
Director, Hip & Knee Joint Preservation Center
Northwestern Medicine Central DuPage Hospital
Northwestern University Feinberg School of Medicine
Warrenville
IL
利益声明
SB receives publication royalties from the following Nova publication: Ligamentous Injuries of the Knee. SB has stock ownership in: AI Digital Ventures, LLC; Edge Surgical; TDA Ventures, LLC; and Joint Preservation Innovations, LLC. SB is on the Board of Directors for AI Digital Ventures, LLC and Joint Preservation Innovations, LLC. He also holds patents pertaining to bone resection related technology. He has received other financial or material support from Smith & Nephew and Graymont Medical, LLC, and has been a paid speaker for the latter. SB also is a board or committee member for the American Academy of Orthopaedic Surgeons and the Arthroscopy Association of North America.
Nikhil N. Verma, MD
Professor
Department of Orthopedic Surgery
Section of Sports Medicine
Rush University Medical Center
Chicago
IL
利益声明
NNV declares the following competing interests: American Orthopaedic Society for Sports Medicine: board or committee member; American Shoulder and Elbow Surgeons: board or committee member; Arthrex, Inc: research support; Arthroscopy: editorial or governing board; publishing royalties, financial or material support; Arthroscopy Association Learning Center Committee: board or committee member; Arthrosurface: research support; Cymedica: stock or stock options; DJ Orthopaedics: research support; Journal of Knee Surgery: editorial or governing board; Minivasive: paid consultant, stock or stock options; Omeros: stock or stock options; Orthospace: paid consultant; Ossur: research support; SLACK Incorporated: editorial or governing board; Smith & Nephew: IP royalties, paid consultant; Smith & Nephew, Athletico, ConMed Linvatec, Miomed, Mitek: research support; Vindico Medical-Orthopedics Hyperguide: publishing royalties, financial or material support.
同行评议者
Jason M. Scopp, MD
Director
Joint Preservation Center at Peninsula Orthopedic Associates
Salisbury
MD
利益声明
JMS declares that he has no competing interests.
鉴别诊断
- 内侧半月板撕裂
- 膝关节内侧软组织挫伤
- 胫骨平台骨折
更多 鉴别诊断指南
- 膝关节后内侧角：关于诊断、分类、治疗和康复的国际专家共识声明
- ACL 和 MCL 复合体合并损伤的治疗：德国膝关节学会（DKG）韧带损伤委员会的共识声明
更多 指南
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