应用双通道“8”字捆绑技术关节镜下治疗后交叉韧带胫骨止点撕脱骨折的临床初探  

Arthroscopic Treatment for the Avulsion Fracture of Posterior Cruciate Ligament Tibial Insertion Using Double-Channel“8”Binding Technique

作　　者：朱锐 兰晓敏 陈丽娟 赵利波 曾一繁 刘洪娟[3] 许凯 Zhu Rui;Lan Xiaomin;Chen Lijuan;Zhao Libo;ZengYifan;Liu Hongjuan;Xu Kai(Department of Orthopaedics,Wuxue Chinese Traditional Medicine Hospital,Huanggang 435400,China;Department of Orthopaedics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Nursing Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]武穴市中医医院骨科,湖北黄冈435400 [2]华中科技大学同济医学院附属同济医院骨科,武汉430000 [3]华中科技大学同济医学院附属同济医院护理部,武汉430030

出　　处：《骨科》2024年第5期445-449,共5页ORTHOPAEDICS

基　　金：湖北省自然科学基金(2022CFB281);同济医院科研基金项目(2022D10)。

摘　　要：目的评价关节镜下双通道“8”字捆绑技术治疗后交叉韧带(PCL)胫骨止点撕脱骨折的手术疗效。方法根据纳入和排除标准,收集2021年6月至2023年6月武穴市中医医院应用关节镜下双通道“8”字捆绑技术治疗PCL胫骨撕脱骨折的9例病人的临床资料。手术前后采用X线、CT和磁共振成像(MRI)评估骨折、韧带损伤及愈合情况。检查并记录术前及术后关节活动度、Lysholm评分、KT-1000等临床参数,以及术后并发症。结果本组病人随访12~24个月,平均16个月。9例病人均顺利完成手术,术后影像资料显示骨折碎片固定良好,术后3个月骨折愈合。与术前相比,关节活动度(133.5°±6.3°vs.31.0°±3.7°)、Lysholm评分[(84.3±5.2)分vs.(36.8±2.5)分]、KT-1000评估[(1.6±0.4)mm vs.(9.6±0.4)mm]均明显改善,差异有统计学意义(P<0.05)。结论关节镜下双通道“8”字捆绑技术可实现PCL止点撕脱骨折治疗“微创化”,可成功恢复PCL止点稳定性和交叉韧带张力,无严重手术并发症,术后膝关节功能恢复良好,使用耗材少,适合在基层医院推广应用。Objective To evaluate the surgical efficacy of the double-channel“8”binding technique under arthroscopy for the treatment of avulsion fractures of the posterior cruciate ligament(PCL)tibial insertion.Methods According to the inclusion and exclusion criteria,the clinical data of 9 patients with PCL tibial avulsion fracture who were treated with double-channel“8”binding technique in Wuxue Chinese Traditional Medicine Hospital from June 2021 to June 2023 were collected.X-rays,CT and magnetic resonance imaging(MRI)were used to evaluate fractures,ligament injuries and healing before and after the operation.The range of motion(ROM),Lysholm score,KT-1000 and other clinical parameters before and after the operation,and postoperative complications were examined and recorded.Results Patients were followed up for 12-24 months,with an average of 16 months.All 9 patients successfully completed the surgery,and postoperative imaging data showed that the fracture fragments were well fixed,and the fracture healed 3 months after surgery.Compared with preoperative data,ROM(133.5˚±6.3˚vs.31˚±3.7˚),Lysholm score(84.3±5.2 vs.36.8±2.5),KT-1000[(1.6±0.4)mm vs.(9.6±0.4)mm]all showed significant improvements,with statistical significance(P<0.05).Conclusion The double-channel“8”binding technique under arthroscopy can realize the“minimally invasive”treatment of avulsion fractures of the posterior cruciate ligament insertion.It has the advantages of fast surgical recovery,little bleeding,low risk of vascular and nerve injury,and economic savings.The surgical effect is definite and suitable for promotion and application in primary hospitals.

关 键 词：后交叉韧带 胫骨止点骨折 关节镜 捆绑技术 

分 类 号：R687.4[医药卫生—骨科学]