关节镜下后交叉韧带胫骨止点撕脱骨折缝合固定术的中远期疗效分析  

Analysis of the Medium-and Long-term Effect of Arthroscopic Suture Fixation for Avulsion Fracture of the Posterior Cruciate Ligament from the Tibia

作　　者：杨波[1] 吴长坤[2] 刘建永[1] 王军[1] 郭永智[1] 姜鑫[1] Yang Bo;Wu Changkun;Liu Jianyong;Wang Jun;Guo Yongzhi;Jiang Xin(Department of Joint Surgery,Weifang People＇s Hospital,Weifang 261041,China;Department of Clinical Medical College,Weifang Medical University,Weifang 261042,China)

机构地区：[1]潍坊市人民医院关节外科,山东潍坊261041 [2]潍坊医学院临床医学院,山东潍坊261041

出　　处：《中国运动医学杂志》2018年第8期646-651,共6页Chinese Journal of Sports Medicine

基　　金：潍坊市科技局项目(201302001)

摘　　要：目的:分析关节镜下后交叉韧带(PCL)胫骨止点撕脱骨折缝合固定术的中远期临床疗效。方法:回顾潍坊市人民医院关节外科2006年1月至2014年12月收治的PCL胫骨止点撕脱骨折患者,56例符合纳入标准接受关节镜下PCL胫骨止点撕脱骨折缝合固定术,其中24例获得有效随访。采用膝关节屈伸活动范围(ROM))、Lysholm膝关节评分和Tegner膝关节运动评分评价膝关节功能,膝关节X线片评价骨折愈合情况,KT2000及后抽屉试验评价膝关节稳定性。结果:24例患者术后获得平均6.62±1.78年随访。术毕,膝关节稳定性恢复,后抽屉试验阴性;术后3天,膝关节X线片显示骨折复位固定良好;术后3个月,膝关节X线片显示骨折愈合良好;术后1年的膝关节ROM、Lysholm膝关节评分、Tegner膝关节运动评分及KT2000结果较术前明显改善,差异均有统计学意义(P<0.05);术后3年与术后1年比较,膝关节ROM、Lysholm膝关节评分、Tegner膝关节运动评分和KT2000结果均无显著性差异(P>0.05)。结论:关节镜下钢丝和orthocord线缝合固定PCL胫骨止点撕脱骨折操作简单、固定可靠、创伤小、恢复快,中远期临床疗效良好。Objective To analyze the medium-and long-term effect of arthroscopic suture fixationfor avulsion fracture of the posterior cruciate ligament（PCL） from the tibia. Methods Between January2006 and December 2014,56 patients with avulsion fracture of the PCL from the tibia were in accor-dance with the inclusive criteria and treated with arthroscopic suture fixation in Weifang People＇s Hos-pital,and 24 of them were followed up effectively. The knee range of motion（ROM）,Lysholm kneescore and Tegner activity score were used to evaluate the knee function. Knee X-ray film was used toobserve the fracture healing. The KT2000 and the post-drawer test were used to test the knee stabili-ty. Results Twenty-four patients were followed up 6.62 ± 1.78 years on the average. After the sur-gery,the stability was recovered and the posterior drawer test was of a negative result. Three days af-ter the surgery,the knee X-ray film showed a good reduction of the avulsion fracture. Three months af-ter the surgery,the knee X-ray film showed good healing of the avulsion fracture. One year after thesurgery,the knee ROM,Lysholm score,Tegner activity score and KT2000 improved significantly com-pared with that before the surgery. However,no significant difference was found in all the measure-ments between three years and one year after the surgery（P〉0.05）. Conclusion Arthroscopic fixation of PCL tibial avulsion fracture with steel wire and orthocord suture is simple,reliable,and of less trau-ma,quick recovery and good effect in the medium and long term.

关 键 词：后交叉韧带 撕脱骨折 关节镜 缝合 

分 类 号：R687.4[医药卫生—骨科学]