小切口可吸收螺钉内固定治疗前交叉韧带胫骨止点撕脱骨折疗效  

EFFECTIVENESS OF MINI INCISION AND ABSORBABLE SCREW FIXATION FOR TREATMENT OF ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE

作　　者：孙和军[1] 李棋[1] 唐新[1] 邓岚兰 郑果[1] 王飞[1] 付维力[1] 李箭[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国修复重建外科杂志》2014年第9期1072-1076,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨小切口切开复位可吸收螺钉内固定治疗前交叉韧带（anteriorcruciateligament，ACL）胫骨止点撕脱骨折的方法和临床疗效。方法2006年1月-2012年7月，收治90例（90膝）ACL胫骨止点撕脱骨折患者。男58例，女32例；年龄10～58岁，平均33．7岁。致伤原因：交通事故伤60例，运动伤22例，摔伤8例。病程1～365d，中位病程106d。合并半月板损伤14例，内侧副韧带损伤5例，外侧半月板前角止点撕脱骨折3例。采用小切口切开复位可吸收螺钉内固定治疗，术后正规康复锻炼。结果术后2例切口延迟愈合，其余患者切口均I期愈合。患者均获随访，随访时间6～72个月，平均40．1个月。x线片检查示，术后3～12个月骨折均达骨性愈合；7例术后4～13个月出现钉尾脱落，均行二期关节镜下钉尾取出术。术后6～12个月患者膝关节活动度、Lysholm评分、Tegner评分及国际膝关节文献委员会（IKDC）评分均较术前显著提高（P〈0．05）。结论对于ACL胫骨止点撕脱骨折，采用小切口切开复位可吸收螺钉内固定治疗具有操作简便、固定可靠、无需二次手术取出螺钉、功能康复满意等优点，是一种安全有效的方法。Objective To investigate the effectiveness of open reduction by mini incision and absorbable screw internal fixation for the treatment of anterior cruciate ligament （ACL） tibial eminence avulsion fracture. Methods Between January 2006 and July 2012, 90 patients （90 knees） with ACL tibial eminence avulsion fracture were treated. There were 58 males and 32 females, aged from 10 to 58 years with an average of 33.7 years. The causes of injury were traffic accident injury in 60 cases, sports injury in 22 cases, and falling injury in 8 cases. The disease duration was 1-365 days with a median of 106 days. Combined injuries included 14 cases of meniscus injury, 5 cases of medial collateral ligament injury, and 3 cases of avulsion fracture of the anterior horn of the lateral meniscus. All patients underwent open reduction by mini incision and internal fixation with absorbable screw. Postoperative rehabilitation exercise was performed. Results Two patients had delayed healing of incision, and others obtained primary healing. All the patients were followed up 6-72 months （mean, 40.1 months）. X-ray examination showed that bone union was achieved in all patients at 3-12 months after operation; nail tail came offin 7 cases at 4-13 months after operation, and the nail tail was taken out under arthroscopy. At 6-12 months after operation, the range of motion （ROM）, Tegner score, Lysholm score, and International Knee Documentation Committee （IKDC） score were significantly increased when compared with preoperative ones （P 〈 0.05）. Conclusion A combination of open reduction by mini incision and absorbable screw internal fixation for the treatment of ACL tibial eminence avulsion fracture has the advantages of easy operation, firm fixation, and satisfactory functional rehabilitation, so it is a safe and effective method for the treatment of ACL tibial eminence avulsion fracture.

关 键 词：膝关节 前交叉韧带胫骨止点撕脱骨折 内固定 可吸收螺钉 

分 类 号：R683[医药卫生—骨科学]