关节镜下空心双螺纹钉治疗前交叉韧带胫骨止点撕脱性骨折  

Arthroscopic treatment of anterior cruciate ligament tibial avulsion fracture using hollow double screw nail

作　　者：黄育强[1] 覃万安[1] 唐葆青[1] 林舟丹[1] 李贵谦[1] 王充 Huang Yuqiang;Qin Wanan;Tang Baoqing(Department of Orthopedics,303 Hospital ofPLA,Nanning Guangxi,530021,China)

机构地区：[1]解放军第303医院骨科,广西南宁530021

出　　处：《生物骨科材料与临床研究》2018年第5期38-40,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨关节镜辅助下空心双螺纹钉治疗前交叉韧带胫骨止点撕脱性骨折的应用价值及手术技巧。方法2011年4月至2016年10月,关节镜下对26例新鲜前交叉韧带胫骨止点撕脱性骨折行断端清理和器械复位,用单枚直径3.0毫米空心双螺纹加压钉固定,强调术后早期关节功能锻炼。本组男性22例,女性4例,年龄13~42岁,平均年龄25.6岁。术前26例患者Lachman试验及前抽屉试验均阳性,Lysholm评分48.85±2.46分,IKDC2000主观膝关节评分52.41±2.26分。结果所有患者均获得随访,随访时间10~15个月,X线片复查提示平均6个月骨折骨性愈合,骨折复位良好。末次随访,全部26例患者术后膝关节屈伸功能恢复好,患者膝关节屈伸活动度122.1°±10.8°,无伸直受限,术后26例患者Lachman试验及前抽屉试验均阴性,Lysholm评分为89.77±3.06分,IKDC2000主观膝关节评分为91.54±2.68分,与术前比较差异有统计学意义(T1=45.937,T2=52.479,P=0.000)。结论关节镜辅助下单枚空心双螺纹钉治疗前交叉韧带胫骨止点撕脱性骨折操作简便,固定牢靠,功能恢复快,创伤小,具有临床推广应用的价值。Objective To study the application value and the surgical technique of hollow double screw nail in the treatment of anterior cruciate ligament tibial avulsion fracture under arthroscopy. Methods From Apr 2011 to Oct 2016, under arthroscopy 26 cases of fresh anterior cruciate ligament tibial avulsion fracture were performed broken end cleaning, reduction and compression with a 3.0 mm diameter hollow double screw nail. The joint functional exercise was indispensable early after surgery. Male 22 cases, female 4 cases, age 13 ~ 42 years（average 25.6 years）. 26 cases anterior drawer test（＋） and Lachman test（＋） preoperatively, Lysholm score 48.85±2.46, IKDC 2000 subject score 52.41±2.26.Results All patients were followed up（ranged from 10 to 15 months）. The X-ray films showed a good reduction and healing of the fracture in 6 months postoperative. At the final follow-up, all the 26 cases had a good recovery of knee flexion and function, The flexion and extension activity of the knee joint was 122.1° ± 10.8° without straight limit. 26 cases had a negative result of anterior drawer test and Lachman test after surgery. Postoperatively, the Lysholm score and IKDC 2000 subject score were separately 89.77± 3.06 and 91.54±2.68 at final follow-up. There was significant difference between preoperation and postoperation of Lysholm score and IKDC 2000 subject score（T1=45.937,T2=52.479,P=0.000）. Conclusion It is convenient and reliable that treat anterior cruciate ligament tibial avulsion fracture with single hollow double screw nail under arthroscopy. It is also helpful for function restoration with minimal invasion, with the clinical application value.

关 键 词：关节镜 空心双螺纹钉 前交叉韧带胫骨止点撕脱性骨折 

分 类 号：R681.8[医药卫生—骨科学]