ACL胫骨止点撕脱骨折固定新方法-23例报道  

A novel technique of cross steel wire loops for internal fixation of ACL tibial avulsion fracture: a 23-case report

作　　者：杨伟毅 张小亮 徐逸生 张葆青 刘金文 曹学伟 YANG Wei-yi;ZHANG Xiao-liang;XU Yi-sheng;ZHANG Bao-qing;LIU Jin-wen;CAO Xue-wei(l Department of Ortho-pedics,Second Affiliated Hospital,Guangzhou University of Chinese Medicine（Guangdong Provincial Hospital of Chinese Medi-cine）,Guangzhou 510120,China;The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guang-zhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院广东省中医院骨三科,广州510120 [2]广州中医药大学第二临床医学院,广州510120

出　　处：《中国矫形外科杂志》2018年第18期1639-1642,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81473698);教育部高等学校博士点科研基金项目(编号:20124425110004);国家中医药管理局中医药标准化项目(编号:SATCM-2015-BZ115;SATCM-2015-BZ173);广东省科技计划项目(编号:2012B061700037;2017ZC0185);广东省财政厅项目(编号:[2014]157号);广东省医学科学技术研究基金项目(编号:A2017215);广东省中医药管理局项目(编号:20164020;20181119);广东省中医院中医药科学技术研究专项(编号:YK2013B2N19;YN2015MS15)

摘　　要：[目的]探讨ACL胫骨止点撕脱骨折固定新方法的临床疗效和优势。[方法]回顾分析2014年1月~2017年12月ACL下止点撕脱骨折患者23例,新方法钢丝交叉固定13例,传统钢丝固定10例,记录两组的手术时间,术前、术后2个月、半年、1年的Lysholm评分以评估功能恢复情况。[结果]钢丝交叉固定与传统钢丝固定两组间的手术时间分别为[(33.00±1.10)min vs(37.76±1.97)min,P<0.05],差异有统计学意义,新方法组手术时间明显短于传统钢丝组。钢丝交叉固定与传统钢丝固定的Lysholm评分分别由术前[(23.64±2.87)分vs(24.67±7.39)分,P>0.05],增加至术后2个月的[(43.64±3.56)分vs(45.67±4.36)分,P>0.05],术后6个月的[(66.21±3.35)分vs(67.67±4.30)分,P>0.05],术后12个月的[(89.79±4.49)分vs(91.00±5.29)分,P>0.05],不同时间点间各组差异均有统计学意义(P<0.05),但相同时间点两组间差异无统计学意义(P>0.05)。[结论]采用钢丝交叉固定ACL止点撕脱性骨折块前端,固定牢靠,功能恢复良好,较传统钢丝固定方式手术时间更短,不失为一个良好的固定方式。[Objective] To evaluate the outcomes and advantages of a novel technique of cross steel wire loops for internal fixation of ACL tibial avulsion fracture. [Methods] A retrospective study was conducted on 23 patients who underwent surgical treatment for ACL tibial avulsion fractures from January 2014 to December 2017. Among them, 13 patients had the fracture fixed by the cross steel wire loops（the novel group）, while the remaining 10 patients underwent fixation with the traditional steel wire technique（the traditional group）. The operation time, Lysholm score preoperatively and at 2 months, 6 months and 1 year after operation were compared between two groups. [Results] The operation lasted（33.00±1.10） mins in the novel group, while（37.76±1.97） mins in the traditional group, with a statistically significant difference between the two groups（P〈0.05）. In term of Lysholm score, both the novel group and the traditional group statistically significantly improved from [（23.64±2.87） vs（24.67±7.39）, P〉0.05] preoperatively, to [（43.64±3.56） vs（45.67±4.36）, P〉0.05] at 2 months postoperatively, [（66.21±3.35） vs（67.67±4.30）, P〉0.05] at 6 months and [（89.79±4.49） vs（91.00 ±5.29）, P〉0.05] with statistical differences among the time points in each group（P〈0.05）, without statistical difference between the two groups at any corresponding time point（P〉0.05）. [Conclusion] The novel cross steel wire loops take advantages of improved fixation, shortened operation time and enhanced functional recovery over the traditional technique for tibial intercondylar eminence avulsion fracture.

关 键 词：前交叉韧带胫骨止点撕脱性骨折 交叉钢丝攀 关节镜 

分 类 号：R683.42[医药卫生—骨科学]