单隧道免打结锚钉治疗后交叉韧带胫骨止点撕脱骨折

doi:10.3877/cma.j.issn.1674-134X.2020.03.020

目的

总结关节镜下利用单隧道免打结锚钉治疗后交叉韧带(PCL)胫骨止点撕脱骨折的效果。

方法

回顾性分析2017年1月至2019年4月淮南朝阳医院骨科收治的PCL胫骨止点撕脱骨折患者，按照纳入排除标准，共纳入36名行关节镜单隧道免打结锚钉内固定治疗的患者。比较每例患者术前及术后6个月的膝关节活动度(ROM)、国际膝关节文献委员会(IKDC)膝关节韧带评估表、Lysholm膝关节功能评分及并发症情况，进行配对立样本t检验。

结果

术后6个月随访ROM范围(t＝－22.231)、IKDC评分(t＝－34.958)、Lysholm评分(t＝－40.802)均比术前明显改善(均为P<0.05)；所有患者均未出现腘窝神经、血管损伤。

结论

采用关节镜下单隧道免打结锚钉内固定技术治疗后交叉韧带胫骨止点撕脱骨折，膝关节功能恢复情况满意。

关键词: 后交叉韧带, 胫骨骨折, 关节镜检查

Objective

To examine the clinical outcomes of arthroscopic single-tunnel suture fixation for posterior cruciate ligament(PCL) tibial avulsion fractures.

Methods

A retrospective analysis was conducted with PCL tibial avulsion fractures treated with arthroscopic single-tunnel suture fixation in the Department of Orthopedics, Chaoyang Hospital in Huainan from January 2017 to April 2019 and 36 patients were included in this studyaccording to the inclusion and exclusion criteria. Comparing the range of motion (ROM), the International Knee Documentation Committee (IKDC) knee ligament assessment andthe Lysholm knee function score of knee joint before operation and 6 months after operation, paired sample t test was performed, .

Results

The ROM (t=-22.231), IKDC score (t=-34.958) and Lysholm score (t=-40.802) at six-month follow-up after the operation were significantly improved compared with those before operation, and the difference was statistically significant (all P<0.05). No popliteal neurovascular bundle injury occurred.

Conclusion

This arthroscopic single-tunnel suture fixation for PCL tibial avulsion fracture may yield good clinical outcomes and satisfactory stability, which can be a useful treatment option for PCL tibial avulsion fracture.

Key words: Posterior cruciate ligament, Tibial fractures, Arthroscopy

表1 术前与术后6个月膝关节功能比较[n＝36，(±s)]

?	ROM(°)	IKDC评分	Lysholm评分
术前	76±9	46±9	43±6
术后6个月	121±6	93±3	93±4
t值	－22.231	－34.958	－40.802
P值	<0.05	<0.05	<0.05

表1 术前与术后6个月膝关节功能比较[n＝36，(±s)]

?	ROM(°)	IKDC评分	Lysholm评分
术前	76±9	46±9	43±6
术后6个月	121±6	93±3	93±4
t值	－22.231	－34.958	－40.802
P值	<0.05	<0.05	<0.05

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Arthroscopic single-tunnel suture fixation for posterior cruciate ligament tibial avulsion fractures

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Arthroscopic single-tunnel suture fixation for posterior cruciate ligament tibial avulsion fractures