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中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (04) : 532 -537. doi: 10.3877/cma.j.issn.1674-134X.2024.04.013

综述

陈旧性前交叉韧带胫骨止点撕脱骨折的诊疗进展
于威1, 王艺凯1, 杨文博1, 孟春庆1, 王洪1, 黄玮1,()   
  1. 1. 430022 武汉,华中科技大学同济医学院附属协和医院骨科
  • 收稿日期:2024-01-14 出版日期:2024-08-01
  • 通信作者: 黄玮
  • 基金资助:
    国家自然科学基金青年项目(82202762)

Progress of non-united anterior cruciate ligament tibial avulsion fracture

Wei Yu1, Yikai Wang1, Wenbo Yang1, Chunqing Meng1, Hong Wang1, Wei Huang1,()   

  1. 1. Orthopedic Surgery Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2024-01-14 Published:2024-08-01
  • Corresponding author: Wei Huang
引用本文:

于威, 王艺凯, 杨文博, 孟春庆, 王洪, 黄玮. 陈旧性前交叉韧带胫骨止点撕脱骨折的诊疗进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 532-537.

Wei Yu, Yikai Wang, Wenbo Yang, Chunqing Meng, Hong Wang, Wei Huang. Progress of non-united anterior cruciate ligament tibial avulsion fracture[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(04): 532-537.

陈旧性前交叉韧带胫骨止点撕脱骨折,指因急性期该骨折未及时治疗或愈合不良,形成骨折间隙纤维骨质增生、软组织卡顿及前交叉韧带(ACL)功能障碍。表现为伸膝障碍、膝关节不稳定等症状。该类骨折处理困难,主要原因包括手术复位及ACL张力恢复困难、膝关节内骨折块和韧带的广泛粘连以及增生阻碍了手术的复位与固定。基于以上问题,近年来涌现了大量治疗陈旧性ACL胫骨止点撕脱骨折的手术方式,但缺乏总结与对比。本文介绍了该病的常见表现及诊断标准并详细回顾了现有已开展的各类手术方式,包括有切开复位内固定(ORIF)、关节镜下复位内固定(ARIF)、关节镜下铆钉复位固定、关节镜下游离骨块去除、前交叉韧带重建等多种治疗方式。本文将对目前常见诊疗方式进行综述,希望为临床陈旧性前交叉韧带胫骨止点撕脱骨折的治疗提供借鉴。

Non-united anterior cruciate ligament tibial avulsion fracture refers to the formation of fibrous osteophytes, soft tissue entrapment, and anterior cruciate ligament (ACL) dysfunction in the fracture gap due to untreated or poorly healed fracture in the acute phase. The fracture is characterized by impaired knee extension and instability of the knee joint. This type of fracture is difficult to manage, mainly because of the difficulty of surgical repositioning and restoration of ACL tension, extensive adhesions and hyperplasia of the fracture mass and ligament in the knee joint prevent surgical repositioning and fixation. Based on these problems, a large number of advances in surgical modalities for the treatment of non-united anterior cruciate ligament tibial avulsion fracture have emerged in recent years, but there is a lack of summary and comparison. This review introduced the common presentations and diagnostic criteria of this disease and review in detail the various surgical procedures that have been performed, including open reduction internal fixation (ORIF), arthroscopic reduction internal fixation (ARIF), arthroscopic reduction anchor fixation, debridement and abrasion of the anterior spine and ACL reconstruction. This article made a review of the above problems to provide reference for clinical work.

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