关节镜下TightRope环扎固定治疗前交叉韧带胫骨止点撕脱性骨折的疗效评估  

Therapeutic effect of arthroscopic TightRope fixation in the treatment of tibial insertion avulsion fractures of the anterior cruciate ligament

作　　者：陆军帅 高礼层 窦帮[1] 朱玮[1] Lu Junshuai;Gao Liceng;Dou Bang;Zhu Wei(Department of Orthopedics,Shanghai Songjiang Central Hospital,Shanghai 201600,China)

机构地区：[1]上海市松江区中心医院骨科,上海201600

出　　处：《创伤外科杂志》2023年第2期118-123,共6页Journal of Traumatic Surgery

摘　　要：目的探讨关节镜下TightRope环扎内固定治疗前交叉韧带(anterior cruciate ligament,ACL)胫骨止点撕脱性骨折的疗效。方法回顾性分析2018年5月—2020年6月上海市松江区中心医院骨科收治的ACL胫骨止点撕脱骨折患者26例,男性18例,女性8例;年龄13~37岁,平均18.9岁;运动伤16例,道路交通伤6例,摔伤4例;骨折分型(Meyers-McKeever-Zaricznyj):Ⅱ型8例,Ⅲ型14例,Ⅳ型4例。患者均行膝关节镜下骨折复位TightRope锁扣带袢钛板环扎固定术。手术前后采用Lysholm膝关节评分、国际膝关节评分委员会(IKDC)及膝关节Tegner评分评价膝关节功能,通过Lachman试验及pivot-shift试验评价膝关节稳定性。记录手术时间、膝关节活动度及术后并发症情况。结果患者均手术顺利,术后随访10~15个月,平均12.5个月。平均手术时长(37.5±6.9)min。末次随访Lysholm、IKDC及膝关节Tegner评分分别为(95.4±4.2)分、(93.5±4.5)分、(7.9±1.5)分,高于术前(45.4±6.4)分、(36.8±5.4)分及(4.8±2.2)分,差异有统计学意义(P<0.001)。结论关节镜下TightRope环扎内固定治疗ACL胫骨止点撕脱性骨折手术疗效明确,手术操作简单,值得推广。Objective To explore the therapeutic effect of arthroscopic TightRope fixation in the treatment of anterior cruciate ligament(ACL)tibial eminence avulsion fractures.Methods Retrospective analysis was conducted on 26 patients with ACL tibial eminence avulsion fractures admitted to the orthopedics department of Shanghai Songjiang District Central Hospital from May 2018 to Jun.2020.There were 18 males and 8 females,aged 13-37 years,mean 18.9 years.The injury mechanism was sports injuries in 16 cases,traffic accidents in 6 and falls in 4.Based on Meyers-McKeever-Zaricznyj fracture classification,there were 8 cases of type II,14 type III,and 4 type IV.All patients underwent arthroscopic fracture reduction and TightRope fixation(buckle+loop titanium plate).Before and after surgery,Lysholm knee score,International Knee Documentation Committee(IKDC)and knee Tegner score were used to evaluate the knee joint function,while the stability of the knee joint was evaluated by Lachman test and pivot-shift test.The operation time,knee range of motion and postoperative complications were also recorded.Results All the surgeries were successfully conducted.The follow-up period was 10-15 months,mean 12.5 months.The operation time was(37.5±6.9)min on average.The Lysholm,IKDC and knee Tegner scores were 95.4±4.2,93.5±4.5 and 7.9±1.5 respectively at final follow-up,significantly higher than that before surgery(45.4±6.4,36.8±5.4,and 4.8±2.2,P<0.001).Conclusion Arthroscopic TightRope fixation in the treatment of ACL tibial eminence avulsion fractures is simple and very effective,and thus worthy of promotion.

关 键 词：前交叉韧带胫骨止点骨折 关节镜 钛板 环扎固定 

分 类 号：R683.42[医药卫生—骨科学]