关节镜下规避骺板“8”字法缝线固定治疗急性儿童前交叉韧带胫骨止点撕脱性骨折  

Arthroscopic Treatment of Acute Anterior Cruciate Ligament Tibial Avulsion Fractures with Figure-of-eight Suture Fixation without Epiphyseal Interference in Children

作　　者：刘玉强[1] 王续鹏[1] 刘宁[1] 梁振雷[1] 胡滨[1] 

机构地区：[1]河南省郑州市骨科医院关节镜科,河南郑州450052

出　　处：《中外医疗》2016年第29期47-49,53,共4页China & Foreign Medical Treatment

摘　　要：目的 选取该院探讨关节镜下实施规避骺板“8”字法缝线固定术治疗急性儿童前交叉韧带胫骨止点撕脱性骨折的临床疗效。方法 2011年3月—2015年3月收治的关节镜下膝关节前内、外侧及辅助正中入路,采用“8”字法缝线固定治疗急性儿童膝关节前交叉韧带胫骨止点撕脱性骨折的22例患者进行回顾性分析,术后随访2年（14~32个月,平均26个月）,对其进行临床评价,包括前抽屉试验、Lachman试验评价膝关节稳定性,根据Lysholm评分、IKDC评分及Tegner评分来术后评价膝关节功能,术后骨折部位X线及CT评价骨折复位愈合情况。结果 术后3个月X线及CT片示骨折均为解剖复位或近解剖复位,均达到骨性愈合。患者前抽屉试验Lachman试验及均为阴性,术后膝关节Lysholm评分（86-96分）（94.7±3.3）分、IKDC评分为（72.2-94.1分）（84.6±3.2）分,Tegner评分7-9分（8.35±1.4）分,较术前差异有统计学意义（P〈0.01）。体检步态均正常,测量双小腿长度差异无统计学意义。结论 关节镜下规避骺板“8”字法缝线固定术治疗急性儿童前交叉韧带胫骨止点撕脱性骨折疗效确切、创伤小、固定可靠、膝关节活动度及功能好,不影响儿童生长发育。Objective To study the treatment efficiency and function recovery of acute anterior cruciate ligament tibial avulsion fractures under arthroscopic with figure-of-eight suture fixation without epiphyseal interference in children. Methods From March 2011 to March 2015,a retrospective analysis was conducted on 22 children patients with anterior cruciate ligament tibial avulsion fracture who were treated arthroscopic used anterolateral、anteromedial、and median portals with figureof-eight suture fixation without epiphyseal interference.The average follow-up for more than two years(range 14 to 32 months,mean 26 months).The follow-up assessment included anterior drawer test、Lachman test、Lysholm、IKDC knees core and the radiological evaluation. Results Fractures were united within 3 months after opemtion in all cases.The knee function was good.The results of anterior drawer test、Lachman test were negative.Postoperatively,the Lysholm knee score was(94.7±3.3)points(86~96)points,the IKDC knee score was(84.6±3.2)points(72.2~94.1)points,the Tegner knee score was 7~9(8.35±1.4)points. The difference was statistically significant(P < 0.01). There was no significant difference in the length of the double leg between the physical examination and the normal gait. Conclusion The arthroscopic figure-of-eight fixation for acute anterior cruciate ligament tibial avulsion fractures in children using suture sisminimally invasive 、 convenient with satisfactory reduction and fixation、without affect children's growth and development、which can benefit the posoperative rehabilitation.

关 键 词：儿童 前交叉韧带 撕脱骨折 缝线 关节镜 骨折固定术 胫骨 

分 类 号：R5[医药卫生—内科学]