儿童青少年前交叉韧带损伤诊疗指南

标题: 儿童青少年前交叉韧带损伤诊疗指南
title: Guidelines for diagnosis and treatment of anterior cruciate ligament injury in children and adolescents
版本: 原创版
version: Original
分类: 标准指南
classification: Standard guideline
领域: 诊疗
field: Diagnosis and Treatment
国家和地区: 中国
Country and region: China
指南使用者: 编写国内儿童青少年前交叉韧带损伤的诊断和治疗指南。为急诊科医师、儿童骨科或运动损伤科医师、护理人员、体能训练师、康复医师和其他医疗专业人员提供诊疗规范指导,为保险公司、政府部门及卫生政策制定者提供相应的参考。为编写国际版“儿童青少年前交叉韧带损伤规范化诊疗指南 ”进行前期准备。
Guide users: To prepare the diagnosis and treatment guidelines for ACL injury in children and adolescents in China. It provides guidance for emergency department dorctors, pediatric orthopedic or sports injury physician, nursing staff, physical training teachers, rehabilitation doctors and other medical professionals, and provides corresponding reference for insurance companies, government departments and health policy makers. It also provide preparation for the international standard diagnosis and treatment guide for ACL injury in children and adolescents.
证据分级方法: Meta analysis
Evidence grading method:
制定单位: 北京积水潭医院
Formulating unit: Beijing JiShuiTan Hospital
注册时间: 2021-06-02
Registration time:
注册编号: IPGRP-2021CN135
Registration number:
指南制订的目的: 2022冬奥会日益临近,冰雪运动蓬勃发展,保障工作需要高标准、严要求,同时随着我国生活水平的不断提高,运动需求也快速释放,这些都对运动伤害预防以及诊疗保障提出了新的要求。据一项长达5年的研究报告,ACL断裂在骨骺未闭的青少年足球运动员膝关节损伤中占31%,青少年ACL损伤的发病率呈逐年升高的趋势。澳大利亚近15年ACL损伤手术例数增长70%,其中多数是14岁以下青少年。但我国儿童青少年运动损伤专业刚刚起步,相对于成人起步早、发展充分的情况而言,儿童运动损伤尚处在萌芽状态,儿童不是成人简单的缩影,诊治方面存在诸多争议问题。 在ACL断裂的青少年患者中,因为推迟手术的严重并发症发生率很高,进行重建术的治疗效果得到认可,国际上提倡尽早完成手术治疗,但是国内因为担心重建手术的骨骺损伤风险,目前是否积极手术还有很大争议,在手术方式 、移植物选择 、固定物选择、手术操作细节、术后康复方案、术式安全效果的评估等方面均未得到一致结论。截止目前,无论国际还是国内,尚未有儿童青少年前交叉韧带损伤诊断和治疗方面的指南出台,急诊医师、儿童骨科或运动损伤科医师、护理人员、体能训练师、康复医师和其他医疗专业人员均缺乏相关的诊疗规范指导,保险公司、政府部门及卫生政策制定者也缺乏相应的参考。因此,对于儿童及青少年前交叉韧带损伤进行系统性回顾研究并建立规范化诊疗指南迫在眉睫。
Purpose of the guideline: The 2022 Winter Olympic Games is approaching, ice and snow sports are booming, and the security work needs high standards and strict requirements. At the same time, with the continuous improvement of China's living standards, the demand for sports is also rapidly released, which puts forward new requirements for sports injury prevention and diagnosis and treatment security. According to a 5-year study, ACL fracture accounts for 31% of the knee joint injuries in adolescent adolescents with patent epiphysis, and the incidence rate of ACL damage is increasing year by year. In Australia, the number of ACL injury surgeries has increased by 70% in recent 15 years, most of which are under 14 years old. However, the major of sports injury for children and adolescents in China has just started. Compared with the situation that adults started early and developed fully, children's sports injury is still in its infancy. Children are not a simple epitome of adults, and there are many controversial issues in diagnosis and treatment. In the adolescent patients with ACL rupture, because of the high incidence of serious complications of delayed surgery, the therapeutic effect of reconstruction is recognized, and it is advocated to complete the surgery as soon as possible in the world. However, because of the risk of epiphyseal injury of reconstruction surgery in China, there is still a lot of controversy about whether to actively operate at present There is no consistent conclusion on the details of operation, postoperative rehabilitation program, evaluation of safety and effect of operation. Up to now, no guidelines on the diagnosis and treatment of ACL injuries in children and adolescents have been published, no matter at home or abroad. Emergency physicians, pediatric orthopedics or sports injury physicians, nurses, physical trainers, rehabilitation physicians and other medical professionals are lack of relevant diagnosis and treatment guidelines Government departments and health policy makers also lack of corresponding reference. Therefore, it is urgent to conduct a systematic review of ACL injuries in children and adolescents and establish standardized guidelines for diagnosis and treatment.