关节镜下带线可吸收双锚钉治疗胫骨髁间嵴撕脱骨折  

ARTHROSCOPIC TREATMENT FOR TIBIAL EMINENCE AVULSION FRACTURE USING ABSORBABLE DOUBLE SUTURE ANCHORS

作　　者：王琪[1] 李众利[1] 刘玉杰[1] 王志刚[1] 蔡谞[1] 魏民[1] 傅仰木[1] 朱娟丽[1] 刘洋[1] 

机构地区：[1]解放军总医院骨科北京,100853

出　　处：《中国修复重建外科杂志》2011年第2期220-224,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨关节镜下带线可吸收双锚钉治疗胫骨髁间嵴撕脱骨折的方法及临床疗效。方法 2007年2月-2009年8月,对18例胫骨髁间嵴撕脱骨折患者于关节镜下应用带线可吸收双锚钉进行骨折复位及固定。男12例,女6例;年龄17～48岁,平均30.6岁。致伤原因:交通事故伤4例,运动伤8例,摔伤6例。左侧7例,右侧11例。前抽屉试验及Lachman试验均呈阳性,Lysholm评分为(53.9±6.7)分,国际膝关节文献委员会(IKDC)2000主观膝关节评分为(58.1±3.7)分。根据Meyers-McKeever胫骨髁间嵴撕脱骨折分型:Ⅱ型10例,Ⅲ型7例,Ⅳ型1例。受伤至手术时间为6～20 d,平均10.2 d。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间13～43个月,平均29.1个月。术后即刻X线片检查示胫骨髁间嵴撕脱骨折复位良好,术后3个月X线片复查示髁间嵴骨折均愈合。末次随访时,患肢膝关节活动范围达0～130°;除2例Lachman试验阴性、前抽屉试验弱阳性外,其余16例两项检查均呈阴性;Lysholm评分为(91.6±4.2)分,与术前比较差异有统计学意义(t=22.100,P=0.000);IKDC2000主观膝关节评分为(92.8±5.9)分,与术前比较差异有统计学意义(t=20.700,P=0.000)。结论关节镜下应用带线可吸收双锚钉治疗胫骨髁间嵴撕脱骨折,能实现有效复位、牢固固定以及骨折临床愈合,具有创伤小、操作简便等优点。Objective To investigate the outcomes of arthroscopic reduction and internal fixation of tibial eminence avulsion fracture using absorbable double suture anchors.Methods Between February 2007 and August 2009,18 patients with tibial eminence avulsion fracture were treated with arthroscopic reduction and fixation using absorbable double suture anchors.There were 12 males and 6 females with an average age of 30.6 years（range,17-48 years）.The disease causes were traffic accident injury in 4 cases,sport injury in 8 cases,and falling from height injury in 6 cases;the locations were left side in 7 cases and right side in 11 cases.The results of the anterior drawer test and Lachman test were positive.According to Meyers-McKeever classification,10 cases were rated as type II,7 as type III,and 1 as type IV fractures.The time from injury to treatment was 6-20 days（mean,10.2 days）.Results Incision healed primarily.All the patients were followed up 29.1 months（range,13-43 months）.The X-ray films showed good reduction of fracture immediately after operation and fracture healing at 3 months.At the last follow-up,the range of motion of knee was 0-130.The results of Lachman test and anterior drawer test were negative in 18 cases and 16 cases,repectively;and the results of anterior drawer test were weakly positive in 2 cases.The mean Lysholm score was significantly improved from 53.9 ± 6.7 preoperatively to 91.6 ± 4.2 postoperatively（t=22.100,P=0.000）.The Inter national knee Documentation Commitee（IKDC） 2000 subject score improved from 58.1 ± 3.7 preoperatively to 92.8 ± 5.9 postoperatively（t=20.700,P=0.000）.Conclusion Arthroscopic treatment using absorbable double suture anchors for tibial eminence avulsion fracture can provide satisfactory reduction,stable fixation,and good healing of the avulsed fragment,which is a minimally-invasive,simple,and effective treatment for patients with tibial eminence avulsion fracture.

关 键 词：髁间嵴撕脱骨折 可吸收双锚钉 前交叉韧带 关节镜技术 

分 类 号：R687.3[医药卫生—骨科学]