改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱骨折  

Treatment of Avulsion Fracture of the Tibial insertion of Posterior Cruciate Ligament with Improved Small Incision

作　　者：李海波[1] 苟永胜[1] 付柏林[1] 王勇[1] 车峥 李蓉[1] 

机构地区：[1]成都市双流县第一人民医院骨科,四川双流610200

出　　处：《中国伤残医学》2016年第14期8-10,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：评价改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折的手术疗效，为临床治疗单纯膝后交叉韧带胫骨止点撕脱骨折提供帮助。方法：2010年9月～2013年9月我院进行改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折共48例，男性33例，女性15例，平均年龄38．5岁；患者采用俯卧位，术中先扪及外侧腓骨头，于膝关节后正中偏内从腓骨头顶点平面向近端延长切口，约2～3cm，沿半腱肌与腓肠肌内侧缘之间用手指钝性分离进入，将胫动静脉、胫神经、小腿三头肌外侧头牵向外侧，小腿三头肌内侧头牵向内侧，将部分后方关节囊切开，显露出膝后交叉韧带胫骨止点撕脱骨折处，将膝后交叉韧带胫骨止点骨折块复位后用可吸收螺钉或锚钉固定。结果：所有病例均获6～36个月随访，平均随访12．5个月。术后骨折均获得满意复位，并在3～6个月获骨性愈合。膝关节功能恢复满意，无明显并发症。结论：经膝关节后正中偏内改良直型小切口入路简单，快捷，安全，创伤更小，恢复膝关节功能疗效满意，值得临床推广运用。Objective：To investigate the effect of treatment of avulsion fracture of the tibial insertion of posterior cruciate ligament（ PCL） through improved small incision .Methods：Patients prone , intraoperative first palpable lateral fibular head , knee joint posterior median offset from the plane to the proximal fibular head vertex incision , about 2-3cm, along the margin between medial gastrocnemius muscle and semitendinosus finger blunt separation into the gastrocnemius soleus , medial head retracted medially , the lateral head of gas-trocnemius soleus , tibialis artery and vein , posterior tibial nerve retracted laterally , open the rear part of the joint capsule , expose the pos-terior cruciate ligament tibial attachment point , cruciate ligament tibial avulsion fracture with absorbable screw block or anchor fixation af -ter reduction.Results：All cases were followed up for 6-36 months, average 12.5 months follow-up.Postoperative fracture was satis-factory reduction, and healed in 3-6 months.Knee joint function recovered satisfactorily , without obvious complications .Conclusion：It has advantages of minimal invasion and enough exposure in the treatment of avulsion fracture of PCL through improved small incision .

关 键 词：后叉韧带 撕脱骨折 改良小切口 

分 类 号：R683.42[医药卫生—骨科学]