自制钢丝导针在后交叉韧带胫骨止点骨折中的应用  

Application of a self-made steel wire guide in the treatment of avulsion fractures of tibial posterior cruciate ligament

作　　者：桂景雄[1] 欧钜伦[1] 王小平[1] 朱小华[1] 郭胜[1] 许国泰[1] 邓志成[1] 

机构地区：[1]南方医科大学附属小榄医院创伤关节外科,广东中山528415

出　　处：《中国骨伤》2016年第5期468-471,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：探讨利用自制钢丝导针在后叉韧带胫骨止点骨折切开复位钢丝内固定手术中辅助引导钢丝进出胫骨隧道的治疗效果。方法：回顾分析2011年2月至2014年6月收治22例后叉韧带胫骨止点骨折,其中男17例,女5例;年龄17~63岁,平均35.6岁。按Meyers分型标准,Ⅱ度9例,Ⅲ度13例。所有患者采用膝关节后内侧倒＂L＂形入路切开复位,术中使用自制钢丝导针辅助完成钢丝内固定手术治疗。结果：22例均利用自制钢丝导针辅助快速完成钢丝穿过胫骨隧道操作。所有患者术后6个月随访X线检查提示骨折愈合良好,膝关节Lysholm评分结果提示功能良好,后抽屉试验阴性。结论：自制钢丝导针简化了钢丝穿过胫骨隧道的手术操作,有效地缩短了手术时间,减少手术创伤和手术并发症,值得临床推广使用。Objective：To explore the effect of a self-made guiding needle of steel wire in guiding the wire through the tibial tunnel for the treatment of avulsion fractures of tibial posterior cruciate ligament with open reduction and wire fixation.Methods：From February 2011 to June 2014,a total of 22 patients with avulsion fractures of tibial posterior cruciate ligament underwent surgical treatments were analyzed,including 14 males and 8 females with an average age of 35.6 years old（ranged,17 to 63 years old）. According to Meyers classification,9 patients were classified as typeⅡ,13 patients were classified as typeⅢ. All the patients underwent open reduction and wire fixation with medial knee ＂L＂ shape approach. A wire guiding needle was used to guide the wire through the tibial tunnel during operation. Results：With the assistance of wire guidance needles,wires passed through the tibial tunnel rapidly during the operation in all the 22 patients. All the patients were followed up,X ray imagings 6 months after operation showed the fractures healed well. The average follow-up time in all patients was 6 months（ranged,6 to 12 months）. The averaged Lysholm knee score in 22 knee was 92.7 ±3.4. All patients ＇ posterior drawer test were negative. Conclusion：Self made wire guiding needle can simplify the operation procedures in which the wires pass through the tibial tunnel,shorten the operation time,reduce the surgical trauma and complications,and be worthy of clinical application.

关 键 词：膝关节 骨折 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]