关节镜下带线锚钉双骨隧道治疗Meyer-Mckeever Ⅲ型胫骨髁间隆突骨折  

An Arthroscopic Technique of Suture Anchor Fixation Through Double Bone Tunnels for Tibial Eminence Avulsion Fracture

作　　者：张坡[1] 王晓民[1] 时昌韩[1] 班兴平 朱闯[1] 戈兵[1] 朱冬承[1] 祝云利 Zhang Po;Wang Xiaomin;Shi Changhan(Department of Joint Surgery,People’s Hospital of Sihong County,Sihong223900,China)

机构地区：[1]江苏省泗洪县人民医院关节外科,江苏泗洪223900 [2]上海长征医院关节外科,上海200003

出　　处：《实用骨科杂志》2019年第11期982-985,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨关节镜下采用2根TwinFix锚钉和Ethibond缝线固定胫骨髁间隆突撕脱性骨折的临床疗效。方法分析2016年1月至2017年12月我科收治的14例Meyer-MckeeverⅢ型胫骨髁间隆突撕脱性骨折患者的临床资料,其中男8例,女6例;年龄18~54岁,(平均37.4±9.12)岁。左膝9例,右膝5例。急性损伤12例,陈旧性损伤2例。按Meyer-Mckeever分型14例均为Ⅲ型,ⅢA型11例,ⅢB型3例。所有患者采用关节镜下复位、锚钉缝线双骨隧道微创固定手术,术后采用膝关节Lysholm评分评估疗效。结果手术时间40~60 min,平均(48.0±5.52)min。14例均获随访,随访时间6~24个月,平均(14.8±4.31)个月。术后3个月复查骨折均愈合,术后6个月Lysholm评分70~98分,平均(94.8±3.4)分;5例随访至24个月,Lysholm评分为(95.6±2.9)分。14例患者查体Lanchman试验均为阴性。13例患者膝关节活动度正常,仅1例(同时修补内侧副韧带)伸直恢复正常,屈曲在90°~100°。结论关节镜下带线锚钉双骨隧道微创治疗胫骨髁间隆突撕脱骨折,具有创伤小、操作简便、固定牢固、膝关节稳定性好、并发症少等优点,临床疗效较好,适于临床推广。Objective To investigate the clinical effect of arthroscopic fixation with TwinFix anchors and double Ethibond sutures on tibial eminence avulsion fracture.Methods Data of 14 patients who have tibial eminence avulsion fracture of Meyer-MckeeverⅢtype from January 2016 to December 2017 in our department were analyzed,including 8 cases of maleand 6 cases of female.They were 18~54 years old(mean 37.4±9.12).There were 9 cases of left knee and 5 cases of right knee.There were 11 cases of typeⅢA and 3 cases of typeⅢB.And there were fresh fracture in 12 cases,dated fracture in 2 cases.All patients accepted arthroscopic reduction and suture anchor fixation through double bone tunnels,and had evaluated by lysholm knee score after operation.Results The mean operation time was(48.0±5.52)mins(range,40~60mins).All the patients were followed up.The mean follow-up period was(14.8±4.31)months(range,6~24 months).All the fractures healed after 3 months of follow-up.The patients were followed up to 6 months,the Lysholm score was(94.8±3.4)(range,70~98).The 5 patients were followed up to 24 months,and the Lysholm score was(95.6±2.9).All 14 patients were negative for Lanchman test.In 13 patients,the range of motion of knee joint was normal,and only 1 patient(repaired medial collateral ligament at the same time)extended and returned to normal,with a flexion of 90°~100°.Conclusion The method of treatment of tibial eminence avulsion fracture with TwinFix suture anchors has following advantages:small in wounding,simple in operation,reliable in fixation,good in knee stability,few in complication,and has excellent clinical effect which is worthy of promotion.

关 键 词：关节镜 带线锚钉 胫骨髁间隆突 撕脱性骨折 固定 

分 类 号：R683.42[医药卫生—骨科学]