摘要
目的比较切开复位内固定和关节镜下或关节镜辅助内固定治疗后交叉韧带（PCL）撕脱骨折的疗效。方法对1998年6月～2005年7月间收治的26例PCL撕脱骨折患者进行回顾性研究，其中切开复位内固定（A组）14例，关节镜下或关节镜辅助复位内固定（B组）12例，通过关节活动度、稳定性检查、国际膝关节文献委员会（IKDC）评级及Lysholm-Tegner膝关节综合功能评分来比较两组患者的疗效。结果两组伸膝功能全部正常；屈膝功能轻度异常，分别为14．3％和8．3％，差异无统计学意义（P〉0．05）。KT2000检测胫骨后移两组平均分别为（2．5±1．7）mm和（3．9±2．1）mm，差异有统计学意义（P〈0．05）。IKDC评级：A组A级57．1％，B级42．9％；B组A级50．0％，B级50．0％，两组间差异无统计学意义（P〉0．05）。Lysholm-Tegner膝关节综合功能评分：A组为（97．5±3．2）分和（7．9±0．7）分，B组为（96．6±3．4）分和（7．4±0．6）分，两组间差异无统计学意义（P〉0．05）。结论对于PCL撕脱骨块〈1．5mm，或粉碎性骨折，或怀疑合并关节其它损伤者可采用关节镜下或关节镜辅助手术；对于撕脱骨块〉1．5mm或陈旧性骨折者应予以开放手术。
Objective To compare the outcomes of open reduction and internal fixation （ORIF） and arthroscopic reduction and internal fixation （ARIF） for fracture avulsion of posterior cruciate ligament （PCL） from the tibia. Methods A retrospective study was conducted on the 26 patients who had been treated in our department from June of 1998 to July of 2005 for PCL avulsion. ORIF was employed for 17 of them and ARIF for 14. Results All the patients were followed up for 1 to 7 years, averaging 1.8 years. The extension function of the knee was normal in all the patients. Mildly abnormal flexion function accounted for 14. 3% in the ORIF group and 8.3% in the ARIF group without significant difference between the two（ P 〉 0. 05）. KT2000 arthrometer testing showed no significant difference in the average posterior translation of tibia [ （2. 5 ± 1.7） mm vs. （3.9 ± 2. 1 ） mm ] between the 2 groups （ P 〈 0. 05） . There was also no significant difference in International Knee Documentation Committee （IKDC） objective evaluation between the 2 groups. In the ORIF group, 57.1% was rated as A and 42. 9% as B, while in the ARIF group, 50. 0% was rated as A and 50. 0% as B （ P 〉 0. 05 ） . By Lysholm-Tegner scales, ORIF averaged 97. 5 ± 3.2 and 7.9 ± 0. 7, while ARIF 96. 6 ± 3.4 and 7.4 ± 0. 6 respectively （ P 〉 0. 05 ） . Conclusions In treatment of fracture avulsion of PCL from the tibia, ORIF and ARIF have its own advantages and disadvantages. If the fracture fragments are smaller than 1.5 mm, or other injury to the knee is suspected, ARIF or arthroscopic procedure should be preferred. If the fragments are larger than 1.5 mm, or the fracture is older than 3 weeks, or the arthroscopic equipment and technique are limited in the hospital, ORIF by posteromedial approach to the gastrocnemius should be adopted.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第5期423-426,共4页
Chinese Journal of Orthopaedic Trauma
关键词
后交叉韧带
膝关节
关节镜
骨折
Posterior cruciate ligament（PCL）
Knee
Arthroscopy
Fracture
