膝关节镜下单隧道Orthocord缝线联合外排铆钉固定治疗胫骨髁间棘骨折  

Knee Arthroscopic-assisted Single Tunnel Orthocord Suture Combined With Outrigger Rivet Fixation for Treatment of Tibial Eminence Fractures

作　　者：高磊 方晓辉 高立波 胡辉东 陆佳俊 吴一雄 李桂军 Gao Lei;Fang Xiaohui;Gao Libo(Department of Orthopaedics, Changzhou Cancer Hospital Affiliated to Suzhou University, Changzhou 213000, China)

机构地区：[1]苏州大学附属常州肿瘤医院骨科,常州213000

出　　处：《中国微创外科杂志》2021年第3期267-271,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：江苏省常州市卫计委科技项目(WZ201917)。

摘　　要：目的探讨膝关节镜下胫骨单隧道Orthocord缝线联合外排铆钉固定治疗胫骨髁间棘骨折的临床疗效。方法2018年1月~2020年7月我们采用膝关节镜下胫骨单隧道Orthocord缝线联合外排铆钉固定治疗胫骨髁间棘骨折,借鉴前交叉韧带(anterior cruciate ligament,ACL)重建时胫骨端隧道收紧固定的原理,以胫骨结节上方与ACL解剖止点中心连线为导向钻取胫骨单隧道。穿入Orthocord超强缝线并交叉穿过ACL,牵拉缝线尾端将ACL连带骨折块拉入骨隧道,胫骨端予外排铆钉收紧固定。结果14例手术顺利,手术时间(84.6±14.2)min。术后无一例感染并发症。骨折愈合时间(4.8±1.0)月。14例随访13~20个月,(15.9±3.2)月,未见内固定物断裂、松动、骨折不愈合等并发症。VAS评分术前,术后1、6个月和末次随访分别为(7.5±0.9)、(4.3±0.5)、(3.2±0.6)、(1.3±0.7)分,术前后比较差异有统计学意义(P<0.05);Lysholm膝关节评分术前,术后1、6个月和末次随访分别为(6.8±1.8)、(37.7±4.9)、(74.6±4.3)、(92.5±4.7)分,术前后比较差异有统计学意义(P<0.05)。结论膝关节镜下胫骨单隧道Orthocord缝线联合外排铆钉固定治疗胫骨髁间棘骨折是一种安全有效的方法,临床疗效满意,手术操作简便。Objective To investigate the clinical effects of knee arthroscopic-assisted single tunnel Orthocord suture combined with outrigger rivet fixation for treating tibial eminence fractures.Methods From January 2018 to July 2020,tibial eminence fractures were treated by arthroscopic-assisted single tunnel Orthocord suture combined with outrigger rivet fixation in our hospital.The principle of the reconstruction of anterior cruciate ligament(ACL)was used.A single tibial tunnel was drilled under the guidance between the tibial tubercle and the anatomic insertion of the ACL.Then the Orthocord suture was passed through the ACL,pulling the fracture fragment into the bone tunnel.Finally the suture was fixed by the outrigger rivet outside the tibial tubercle.Results The process of the operations was smooth without infection.The operation time was(84.6±14.2)min.The healing time of fracture was(4.8±1.0)months.All the patients were followed up for 13-20 months[(15.9±3.2)months].No internal fixation fracture,loosing,non-union or other complications were found.The VAS scores were(7.5±0.9),(4.3±0.5),(3.2±0.6),and(1.3±0.7)points preoperatively,1 and 6 months postoperatively,and at the last follow-up,respectively,and the difference was statistically significant(P<0.05).The Lysholm knee scores were(6.8±1.8),(37.7±4.9),(74.6±4.3),and(92.5±4.7)points preoperatively,1 and 6 months postoperatively,and at the last follow-up,respectively,and the difference was statistically significant(P<0.05).Conclusion Arthroscopic-assisted single tunnel Orthocord suture combined with outrigger rivet fixation for the treatment of tibial eminence fractures is effective,safe and simple.

关 键 词：胫骨髁间棘骨折 单隧道 外排铆钉 Orthocord缝线 膝关节镜 

分 类 号：R68[医药卫生—骨科学]