不可吸收缝线领带结套扎固定技术治疗胫骨髁间隆突撕脱骨折  

ARTHROSCOPIC REDUCTION AND FIXATION OF TIBIAL INTERCONDYLAR EMINENCE AVULSION FRACTURES USING NONABSORBABLE SUTURE WITH NECKWEAR KNOT LOOP LIGATURE

作　　者：刘玉杰[1] 王俊良[1] 齐玮[1] 王志刚[1] 李春宝[1] 魏民[1] 李众利[1] 蔡谞[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8期903-906,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨关节镜下经皮撬拨复位、Ethibond不可吸收缝线领带结套扎固定技术治疗胫骨髁间隆突撕脱骨折的疗效。方法 2003年2月-2008年12月,收治胫骨髁间隆突撕脱骨折28例。男15例,女13例;年龄14～45岁,平均19.5岁。左膝16例,右膝12例。致伤原因:交通事故伤11例,运动伤10例,扭伤7例。骨折根据Meyers-McKeever分型:Ⅲ型18例,Ⅳ型10例。X线片示胫骨髁间隆突撕脱骨折移位。受伤至手术时间4～12 d,平均7 d。采用关节镜下经皮撬拨复位、Ethibond不可吸收缝线绕前交叉韧带胫骨附着处进行领带结套扎固定技术治疗。结果术后患者切口均Ⅰ期愈合,无感染及血管、神经损伤等并发症发生。28例均获随访,随访时间12～66个月,平均26个月。X线片复查示骨折均于术后9～13周愈合,平均11周。末次随访时,患者均恢复伤前生活和运动水平;膝关节稳定,无跛行、绞锁和髁间窝撞击表现;膝关节伸屈活动度0～130°。Lachman试验和前抽屉试验均呈阴性。末次随访时,膝关节Lysholm评分为(93.5±2.5)分,与术前(29.0±2.2)分比较,差异有统计学意义(t=53.000,P=0.000)。结论关节镜下经皮撬拨复位、不可吸收缝线领带结套扎固定技术治疗胫骨髁间隆突撕脱骨折创伤小,复位固定可靠,有利于早期功能锻炼,可获得满意疗效。Objective To investigate the effectiveness of percutaneous reduction by leverage and fixation using nonabsorbable suture with neckwear knot loop ligature to treat tibial intercondylar eminence avulsion fractures under the arthroscope. Methods Between February 2003 and December 2008, 28 patients with tibial intercondylar eminence avulsion fractures were treated, including 16 left knees and 12 right knees. There were 15 males and 13 females with an average age of 19.5 years （range, 14-45 years）. The injury causes included traffic accident injury in 11 cases, sport injury in 10 cases, and sprain injury in 7 cases. Based on Meyers-McKeever classification, there were 18 cases of type III and 10 cases of type IV. The X-ray films showed the tibial intercondylar eminence displaced fracture. The mean time between trauma and operation was 7 days （range, 4-12 days）. All patients were treated surgically with an arthroscopically assisted reduction by leverage and fixation using 5-0 Ethibond suture with neckwear knot loop ligature. injuries of nerves and vessels. Twenty-eight patients were films showed fracture healing within 9-13 weeks （mean, Results All incisions healed by first intention without infection or followed up 26 months on average （range, 12-66 months）. The X-ray 11 weeks）. At last follow-up, all patients were able to return to their pre-injury activity and daily life. The knee joint was stable with no limp or impingement of intercondylar fossa. The knee joint range of motion was 0-130°. The results of Lachman and anterior drawer tests were negative in all patients. At last follow-up, the Lysholm score was 93.5±2.5, showing significant difference when compared with the preoperative one （29.0±2.2, t=53.000, P=0.000）. Conclusion Percutaneous reduction by leverage and fixation using nonabsorbable suture with neckwear knot loop ligature is minimally invasive and satisfied reduction and fixation in treating the tibial intercondylar eminence avulsion fracture under the arthroscope, so it is benefi

关 键 词：胫骨髁间隆突撕脱骨折 前交叉韧带 内固定术 领带结套扎固定 关节镜 

分 类 号：R687.3[医药卫生—骨科学]