关节镜下钢丝固定治疗前交叉韧带胫骨止点撕脱骨折  

Arthroscopic Reduction and Internal Fixation of Avulsion Fracture of Anterior Cruciate Ligament from Tibial Eminence with Stainless Steel Wire

作　　者：卢华定[1] 史德海[1] 董云旭[2] 王昆[1] 曾春[1] 

机构地区：[1]中山大学附属第三医院骨科,广东省广州市510630 [2]中山大学附属第三医院放射科,广东省广州市510630

出　　处：《中国骨与关节损伤杂志》2011年第2期112-114,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨关节镜下钢丝内固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效。方法自2003年1月～2009年6月采用关节镜下复位钢丝内固定治疗13例移位的ACL胫骨止点撕脱骨折,术后可调式支具保护,积极康复训练。采用Lysholm评分对手术前、后膝关节功能进行评价,术后定期复查膝关节X线片。结果 13例获6～32个月随访,平均l4个月。无关节感染、意外损伤、关节僵硬、伸直受限、骨折不愈合等并发症发生。术后3个月X线片示骨折愈合,所有患者膝关节活动度正常,Lachman试验和前抽屉试验阴性。术前Lysholm评分(39.4±9.98)分,术后6个月提高至(95.2±2.94)分,术前术后比较t=24.001,P<0.01,差异有统计学意义。结论关节镜下复位钢丝内固定治疗ACL胫骨止点撕脱骨折方法简便、适用范围广、创伤小、术后功能恢复满意,是治疗此类骨折较理想的选择。Objective To investigate the therapeutic efficacy of arthroscopie internal fixation of avulsion fracture of the anterior cruciate ligament （ACL） from the tibial eminence with stainless steel wire.Methods Thirteen cases of displaced avulsion fi＇acture of the ACL from the tibia] eminence were treated by arthroscopic reduction and internal fixation with stainless steel wire from January 2003 to June 2006. Adjustable brace was used for protection after surgery, and active rehabilitation training was conducted. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments postoperatively. Results Thirteen cases were followed up for 6 to 32 months and the average time was 14 months. No complications of intraarticular infection, iatrogenic injury, anchylosis, loss of knee extension, or nonunion of fi＇acturc were found. X-ray films revealed good bone union in all the 13 cases three months after surgery. No knee instability was detected, and knee flexion and extension function was normal in all patients. The Lysholm scores were improved from 39.4±9.98 preoperatively to 95.2±2.94 postoperatively, with significant statistical difference by the student-t test （t = 24.001,P 〈0.01）. Conclusion Arthroscopie reduction and internal fixation with stainless steel wire in the treatment of avulsion fiacture of the anterior cruciate ligament fi＇om the tibial eminence has advantages of simplicity, broad indications,minimal invasion, and rapid postoperative recovery. It is believed as an ideal choice for such avulsion fracture of the anterior eruciate ligament from the tibial eminence.

关 键 词：前交叉韧带 撕脱骨折 关节镜 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]