关节镜下套索环缝合联合带袢钛板治疗前交叉韧带胫骨止点骨折的疗效分析  

Efficacy Analysis of Arthroscopic Lasso-Loop Stitch Combined with Endobutton on the Treatment of Tibial Insertion Fractures of Anterior Cruciate Ligament

作　　者：朱文科 俞臻 王雨辰[1] 俞伟忠[1] 何樟宁 贾川 ZHU Wenke;YU Zhen;WANG Yuchen;YU Weizhong;HE Zhangning;JIA Chuan(Orthopedics Department,Changzhou Wujin Traditional Chinese Medicine Hospital,Changzhou 213003,Jiangsu China;The Third Affiliated Hospital of Suzhou University,Changzhou 213003,Jiangsu China)

机构地区：[1]常州市武进中医医院骨伤科,江苏常州213161 [2]苏州大学附属第三医院

出　　处：《中国中医骨伤科杂志》2023年第2期52-57,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：常州市武进区科技计划(社会发展)项目(WS202101)。

摘　　要：目的:探讨关节镜下套索环缝合联合带袢钛板治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效。方法:选取2017年5月至2020年5月26例前交叉韧带止点骨折患者,均符合纳入标准。其中男17例,女9例;年龄为18~49岁;均行关节镜下套索环缝合联合带袢钛板治疗。比较术后X线片愈合情况,术前1 d与术后2周膝关节周径的差值及术前和术后6个月的Lysholm评分及IKDC评分。结果:26例患者均得到随访,均未发生术后感染,手术时间为40~60 min,平均为(51.88±5.61)min;出血量为5~10 mL,平均为(7.23±1.45)mL;术后随访时间为7~12个月,平均为(9.34±2.08)个月;术中及术后3个月和6个月前抽屉及Lachman试验均为阴性;术后膝关节周径为(40.62±3.92)cm,较术前(42.63±3.38)cm改善明显,差异有统计学意义(P<0.05);术后6个月的Lysholm评分为(88.19±4.81)分,较术前(24.69±4.31)分明显提高。术后6个月的IKDC评分为(79.50±1.88)分,较术前(44.15±2.51)分明显改善。结论:关节镜下套索环缝合联合带袢钛板治疗前交叉韧带胫骨止点骨折操作简单,复位精准,术后膝关节功能恢复快,值得临床推广应用。Objective:To investigate the clinical efficacy of arthroscopic lasso ring suture combined with loop titanium plate on the treatment of anterior cruciate ligament(ACL) tibial insertion avulsion fracture. Methods:26 patients with ACL insertion fracture were selected from May 2017 to May 2020. All patients met the inclusion criteria, including 17 males and 9 females, aged 18 to 49 years old. All patients were treated with lasso-ring suture combined with loop titanium plate under arthroscopy. The postoperative X-ray healing, the difference of knee circumference between 1 d before operation and 2 weeks after operation, and Lysholm score and IKDC score before operation and 6 months after operation were compared. Results:All 26 patients were followed up effectively, and no postoperative infection occurred. The operation time was 40 to 60 min((51.88±5.61) min), and the blood loss was 5 to 10 mL((7.23±1.45) mL). The follow-up time was 7 to 12 months((9.34±2.08) months). Drawer and Lachman tests were negative during the operation and 3 and 6 months after the operation. The circumference of knee joint after operation was(40.62±3.92) cm, which was significantly improved compared with that before operation(42.63±3.38) cm(P<0.05), with statistical significance. The Lysholm score at 6 months after operation was 88.19±4.81, which was significantly higher than that before operation(24.69±4.31). The IKDC score at 6 months after operation was 79.50±1.88, which was significantly higher than that before operation(44.15±2.51). Conclusion:Arthroscopic lasso-loop stitch combined with endobutton on the treatment of anterior cruciate ligament tibial insertion fractures is simple. The reduction is accurate, and the postoperative knee function recovery is fast. It is worthy of clinical recommendation.

关 键 词：前交叉韧带 胫骨止点骨折 关节镜 套索环缝合 带袢钛板 

分 类 号：R683.42[医药卫生—骨科学]