探讨关节镜下单隧道悬吊固定治疗前交叉韧带胫骨止点撕脱骨折的方法和临床疗效。

回顾性分析2015年3月至2018年1月间27例膝关节前交叉韧带胫骨止点撕脱骨折患者，男19例，女8例，年龄平均(28±8)岁，排除骨质疏松、病理性骨折等。骨折按Meyers-Mckeever分型，Ⅱ型9例，Ⅲ型14例，Ⅳ型4例。本组患者均采用关节镜下单隧道缝线环绕固定方法治疗。定期复查X片观察骨折愈合情况，Lysholm评分系统评价膝关节功能，疼痛采用视觉模拟法(VAS)进行评定；主观因素包括肿胀、关节稳定性及参加工作满意度；记录并发症。术前术后评分比较采用配对样本t检验。

术后随访平均(18±6)个月。骨折均在3个月内愈合，无感染、内固定松动等并发症。27例患者膝关节功能恢复正常，26例患者末次随访Lachman试验及前抽屉试验均阴性，1例患者随访体检时膝关节Ⅱ°松弛，自诉无腿软不稳现象。视觉模拟VAS评分平均为(1.0±0.6)分。术前膝关节Lysholm评分(42±9)，末次随访膝关节Lysholm评分(90±6)，差异有统计学意义(t ＝22.365，P <0.01)。主观评价所有患者日常生活无明显影响。

关节镜下单隧道悬吊固定缝线技术治疗前交叉韧带止点撕脱骨折，手术操作创伤小，简单方便，骨折复位固定牢靠，术后功能恢复快，是一种较理想的手术方法。

To explore clinical outcomes of arthroscopic therapy for tibial eminence avulsion fracture with single-tunnel suspended fixation.

From March 2015 to Jan 2018, 27 cases of the avulsion fracture of anterior cruciate ligament were analyzed retrospectively. This series cases included eight females and 19 males, with mean age of (28±8) years. The cases with osteoporosis and pathologic fracture were excluded. According to Meyers-Mckeever system, there were nine cases of type Ⅱ, 14 cases of type Ⅲ and four cases of type Ⅳ. All the cases were treated under arthroscopy with single tunnel suspended fixation technique, which unabsorbable suture passed through anterior cruciate ligament and fixed with endobutton plate at the outer side of single tunnel. They were followed up periodically by radiological examination. At the final follow-up, Lysholm scoring and visual analog scale(VAS) were recorded. Subjective factors included swelling, joint stability and job satisfaction. Complications were also recorded. The paired t- test was used to compare scores.

The follow-up lasted for average of (18±6) months. All the cases achieved reduction and union during three months postoperatively, without infection and fixation failure. There was one sign of instability in one patient, but he reported no pain and any subjective instability. The mean preoperative and postoperative Lysholm knee scores were (42±9) and (90±6) points at the time of first visit and last follow-up respectively. The difference was statistically significant (t=22.365, P<0.01).

Arthroscopic surgery for avulsion fracture of anterior cruciate ligament using single tunnel suture technique is feasible, which shows less trauma, satisfactory reduction, reliable fixation, quick recovery of function and low complication.