摘要
目的探讨关节镜下不可吸收缝线联合微型钢板固定治疗前交叉韧带(anterior cruciate ligament,ACL)胫骨止点撕脱骨折的方法及疗效。方法 2009年1月-2012年3月,收治32例ACL胫骨止点撕脱骨折患者。男18例,女14例;年龄12～40岁,平均17.5岁。致伤原因:交通事故伤15例,运动伤6例,摔伤11例。受伤至手术时间为7～18 d,平均9.5 d。Lachman试验均为阳性。膝关节Lysholm评分为(52.13±4.22)分,国际膝关节文献委员会(IKDC)评分为(44.82±2.44)分。按照Meyers-McKeever分型标准:Ⅱ型12例,Ⅲ型20例。关节镜辅助下骨折撬拨复位后,采用Ethibond不可吸收缝线绕行呈"八"字形的两胫骨隧道并掌指骨微型钢板悬吊固定。结果术后切口均Ⅰ期愈合,无关节感染、皮肤坏死等并发症发生。患者均获随访,随访时间12～50个月,平均22.4个月。术后12周患膝关节Lachman试验均为阴性。末次随访时,3例遗留膝关节伸直受限,其余患者伸膝范围均正常;屈膝范围均正常。Lysholm评分为(94.19±0.93)分,IKDC评分为(94.35±1.22)分,均较术前显著提高,比较差异有统计学意义(t=55.080,P=0.000;t=101.715,P=0.000)。结论关节镜下不可吸收缝线联合微型钢板固定治疗ACL胫骨止点撕脱骨折具有手术创伤小、固定牢固、操作简便的优点,术后患者膝关节功能恢复良好。
Objective To evaluate the surgical techniques and effectiveness of arthroscopic treatment of anterior cruciate ligament （ACL） tibial eminence avulsion fracture with non-absorbable suture fixation combined with the mini- plate. Methods Between January 2009 and March 2012, 32 patients with ACL tibial eminence avulsion fractures were treated. There were 18 males and 14 females, aged 12-40 years （mean, 17.5 years）. The injury causes included traffic accident injury in 15 cases, sport injury in 6 cases, and falling injury in 11 cases. The time from injury to operation ranged 7-18 days with an average of 9.5 days. Before operation, the results of Lachman test were all positive; the Lysholm score was 52.13 ± 4.22 and the International Knee Documentation Committee （IKDC） score was 44.82 ± 2.44. According to Meyers-McKeever classification criteria, there were 12 cases of type II and 20 cases of type III. After arthroscopic poking reduction of fracture, tibial eminence avulsion fractures were fixed with the Ethibond non-absorbable sutures bypass figure-of-eight tibial tunnel combined with the metacarpal and phalangeal mini-plate. Results Primary healing was obtained in all incisions; no joint infection or skin necrosis occurred after operation. All patients were followed up with an average time of 22.4 months （range, 12-50 months）. The patients showed negative Lachman test at 12 weeks after operation. Except 3 patients having knee extension limitation at last follow-up, the knee extension range of motion （ROM） was normal in the other patients; the knee flexion ROM was normal in all patients. The Lysholm score and IKDC score were significantly improved to 94.19 ± 0.93 and 94.35 ± 1.22 at last follow-up, showing significant differences when compared with preoperative values （t=55.080, P=0.000; t=101.715, P=0.000）. Conclusion The arthroscopic treatment of ACL tibial eminence avulsion fracture with Ethibond non-absorbable suture fixation combined with mini-plate is an effective procedure with the ad
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2013年第9期1041-1044,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
前交叉韧带
胫骨止点撕脱骨折
关节镜
不可吸收缝线
微型钢板
Anterior cruciate ligament
Tibia1 eminence avulsion fracture
Arthroscopy
Non-absorbable suture
Mini-plate
