关节镜下自体韧带固定治疗后交叉韧带胫骨止点撕脱骨折17例疗效分析  

Effect of autologous ligament reconstruction for tibial avulsion fracture of posterior cruciate ligament under arthroscopy

作　　者：黄浩[1] 王庆 江永发[1] 潘勇泉[1] HUANG Hao;WANG Qing;JIANG Yongfa;PAN Yongquan(Department of Orthopaedics,The People's Hospital of Huadu District,Guangzhou,Guangdong 510800,China;Department of 0rthopaedics and Sports Injuries,Guangzhou General Hospital of Southern Military Area Command of Chinese PLA,Guangzhou,Guangdong 510030,China)

机构地区：[1]广州市花都区人民医院骨科,广东广州510800 [2]南部战区总医院骨病与运动损伤科,广东广州510030

出　　处：《安徽医药》2021年第8期1521-1523,共3页Anhui Medical and Pharmaceutical Journal

基　　金：广东省科技计划基金(2014A020212258)。

摘　　要：目的分析关节镜下自体韧带“8”字固定法重建后交叉韧带胫骨止点撕脱骨折的临床疗效。方法回顾性分析2013年1月至2017年6月广州市花都区人民医院收治纳入研究的后交叉韧带胫骨止点撕脱骨折病人17例,均行关节镜下后交叉韧带胫骨止点撕脱骨折自体半腱肌重建术,对比病人术前、术后VAS疼痛评分、IKDS膝关节评分、病人满意度。结果病人随访31个月,时间范围为11~39个月,术后末次随访病人膝关节活动度较术前明显增加[(133.24±3.01)°比(36.29±2.82)°],视觉模拟(VAS)疼痛评分[(1.12±0.99)分比(6.06±1.34)分]、IKDS评分[(89.12±2.52)分比(37.94±2.11)分]均较术前明显改善,差异有统计学意义(P<0.05)。其中有1例病人术后存留关节活动时疼痛,对手术效果不满意,16例病人表示满意,满意率94.1%。结论关节镜下后交叉韧带胫骨止点撕脱骨折自体韧带重建效果良好,重建后对后交叉切割概率小,自体韧带无排异反应,功能恢复快。Objective To analyze the clinical effect of autologous ligament reconstruction for tibial avulsion fracture of posterior cruciate ligament(PCL).Methods Data of 17 patients with tibial avulsion fracture of PCL admitted to The People’s Hospital of Huadu District from January 2013 to June 2017 were retrospectively analyzed.All of the patients underwent arthroscopy exploration and semitendinosus reconstruction for the avulsion fracture,and the patients’preoperative and postoperative visual analogue scale(VAS)pain scores,international knee documentation committee(IKDC)scores and satisfaction were compared.Results The patients were followed up for 11 to 39 months,with an average of 31 months.At the last follow-up after surgery,the range of motion(ROM)[(133.24±3.01)°比(36.29±2.82)°]was significantly increased,and both the VAS pain score[(1.12±0.99)score vs.(6.06±1.34)score]and the IKDC scores[(89.12±2.52)score vs.(37.94±2.11)score]significantly improved(P<0.05).One patient had pain when preserving joint activity after surgery,and he was not satisfied with the operation.The other 16 patients were satisfied with the surgeries,the satisfaction rate being 94.1%.Conclusion The autologous ligament reconstruction in the treatment of tibial avulsion fracture of PCL under arthroscopy has good effect,with low risk of posterior cruciate cutting,no rejection to autologous ligament,and quick recovery of function.

关 键 词：胫骨骨折 骨折 撕脱性 后交叉韧带重建 膝关节镜 后交叉韧带 止点撕脱骨折 自体韧带重建 

分 类 号：R687.3[医药卫生—骨科学]