摘要
目的探讨关节镜下爱惜邦不可吸收缝线锚钉固定法治疗前交叉韧带（ACL）胫骨止点撕脱骨折的手术疗效。方法回顾性分析2013年7月-2014年6月ACL胫骨止点撕脱骨折患者20例，男12例，女8例；年龄18～41岁，平均25．3岁。Meyers—McKeever分型为Ⅱ型或Ⅲ型骨折。Lachman试验和前抽屉试验均为阳性。所有患者均在伤后3周内手术，均在关节镜下使用爱惜邦不可吸收缝线联合锚钉复位固定ACL胫骨止点。随访复查X线片，采用Lyshohn评分和国际膝关节文献委员会（IKDC）评分对膝关节功能进行评价。结果手术时间45～70rain，平均50min。出血量5—15ml，平均10ml。随访12～24个月，平均16．3个月。所有患者术后复查X线片提示ACL胫骨止点撕脱骨折均复位及愈合良好。术后Lachman试验和前抽屉试验均为阴性，膝关节功能恢复良好。术前Lysholm评分为42～61分[（51．1±6．2）分]，末次随访时为89～96分[（93．5±2．3）分]（P〈0．05）；术前IKDC评分为46—68分[（55．2±7．0）分]，末次随访时为84～96分[（91．0±3．9）分]（P〈0．05）。结论关节镜下爱惜邦不可吸收缝线锚钉固定法治疗ACL胫骨止点撕脱骨折，其操作简单，创伤小，固定可靠，功能恢复良好，临床疗效满意。
Objective To investigate the clinical effect of Ethibond suture and anchor fixation by arthroscopic technique for the treatment of avulsion fracture of the anterior cruciate ligament （ACL） tibial insertion. Methods Twenty patients with avulsion fracture of the ACL tibial insertion hospitalized between July 2013 and June 2014 were collected retrospectively. There were 12 males and 8 females, aged 18-41 years （mean, 25.3 years）. All patients were identified with type Ⅱ and type Ⅲ fractures according to the Meyers-McKeever classification. Results of Lachman test and anterior drawer test were both positive. All patients accepted the operation that avulsion fracture of the ACL tibial insertion was treated with the Ethibond suture and anchor fixation by arthroscopic technique within 3 weeks after injury. Follow-up X-ray examinations were carried out to evaluate the bone union. Lysholm and international knee documentation committee （IKDC） scores were used to evaluate the function of knee joint postoperatively. Results Operation time was 45-70 min （mean, 50 min）. Blood loss was 5-15 ml （mean, 10 ml）. Follow-up was conducted for 12-24 months （mean, 16. 3 months）. Postoperative X-ray showed the reduction was satisfactory. Lachman test and anterior drawer test were both negative after operation. Knee functions were recovered to nornml. Lysholm and IKDC seores were 89 -96 points [ （93.5 ± 2.3 ）pointsJ and 84-96 points [ （91.0 ± 3.9） points ] respectively at the final follow-up, improved eompared to the preoperative 42-61 points [ （51.1 ± 6.2） points ] and 46-68 points [ （55.2 ± 7.0 ） points ] （ both P 〈 0. 05 ）. Conclusion Arthroscopic Ethibond suture and anchor fixation for avulsion fracture of the ACL tibial insertion is an effective procedure with the advantages of small trauma, reliable fixation, good functional recovery and satisfactory clinical effect.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2016年第7期621-625,共5页
Chinese Journal of Trauma
基金
基金项目：国家自然科学基金（81401790）
江西省自然科学基金（20151BAB205053）
江西省卫生计生委科技计划（20155105）
关键词
前交叉韧带
胫骨骨折
关节镜
缝合锚
骨折固定术
Anterior crueiale ligament
Tibial fractures
Arthroscopes
Suture anchors
Fracture fixation
作者简介
段平国，电话：13807913585，Email：duan．pinggu028@gmail．com
通信作者：徐屹，电话：18607918730，Email：xuyi9856@sina．com
