关节镜下“三缝线–三叉星”技术固定前交叉韧带下止点撕脱骨折  

Arthroscopic“Three Suture-Trident Star”technique for fixation of avulsion fractures at the tibial insertion of the anterior cruciate ligament

作　　者：孙超[1] 徐稳 陈雪 王庆玲 薛朝亚 梅宇[2] Sun Chao;Xu Wen;Chen Xue;Wang Qingling;Xue Chaoya;Mei Yu(Qinhuangdao Hospital,Peking University Third Hospital,Qinhuangdao 066000,China;Peking University Third Hospital,Beijing 100080,China)

机构地区：[1]北京大学第三医院秦皇岛医院,河北秦皇岛066000 [2]北京大学第三医院,北京100191

出　　处：《中国运动医学杂志》2024年第8期597-604,共8页Chinese Journal of Sports Medicine

基　　金：秦皇岛市科技计划项目(202301A128)。

摘　　要：目的:探讨关节镜下“三缝线–三叉星”技术治疗前交叉韧带下止点撕脱骨折的临床疗效。方法:回顾性分析2019年1月至2022年1月期间,46例接受关节镜下“三缝线–三叉星”技术治疗的前交叉韧带(ACL)下止点撕脱骨折治疗患者的病例资料,包括术前和术后的体格检查(稳定性和活动度)、国际膝关节文献委员会(IKDC)评分、Tegner活动等级评分、疼痛视觉模拟评分(VAS)、术后满意度、并发症情况以及重返运动时间等。将术后6个月、术后12个月的样本数据分别与术前的样本数据进行比较。结果:46例患者中男性26例,女性20例,平均年龄37.6±10.3岁,平均随访时间为14.4±2.7个月。术前与术后6个月、12个月的IKDC评分分别为59.7±5.4、86.1±5.7、89.5±5.0(P<0.001);Lysholm评分分别为56.7±5.0、84.8±4.4、90.6±4.2(P<0.001);Tegner评分分别为0.5±0.3、4.6±1.7、6.6±2.1(P<0.001);VAS评分分别为7.1±1.1、1.7±1.0、0.7±0.8(P<0.001)。术后满意度评为优秀42例、良好3例、一般1例,优良率达97.8%。术后6个月、12个月随访时,体格检查的前抽屉试验、Lachman试验结果均为阴性;重返运动平均时间为8.3±2.5个月。所有患者撕脱骨折均一期愈合,未发生感染、关节僵硬、骨折块松动移位及畸形愈合等术后并发症,均无需二次手术。结论:关节镜下“三缝线–三叉星”技术对前交叉韧带下止点撕脱骨折患者具有显著的临床疗效,能有效恢复术后关节的稳定性和功能。Objective To explore the clinical efficacy of the arthroscopic“Three Suture-Trident Star”technique in treating avulsion fractures of the distal point of the anterior cruciate ligament(ACL). Methods A retrospective analysis was conducted on 46 patients undergoing the arthroscopic“Three SutureTrident Star” technique for ACL distal point avulsion fractures between January 2019 and January2022. The physical examinations(including stability and mobility), International Knee Documentation Committee(IKDC) scores,Tegner activity level scores,visual analogue scale(VAS) scores,postoperative satisfaction,complications,and return-to-sports time were compared among before the operation,as well as 6 and 12 months after the operation,respectively. Results The average age of the 46 patients,26 male and 20 female,was 37.6 ± 10.3 years. Their average follow-up period was 14.4 ±2.7 months. The IKDC scores before surgery and at 6 and 12 months postoperatively were 59.7 ± 5.4,86.1 ± 5.7,and 89.5 ± 5.0(P<0.001),respectively,the corresponding Lysholm scores,Tegner scores and VAS scores were 56.7 ± 5.0,84.8 ± 4.4 and 90.6 ± 4.2(P<0.001),0.5 ± 0.3,4.6 ± 1.7 and 6.6 ± 2.1(P<0.001),as well as 7.1 ± 1.1,1.7 ± 1.0 and 0.7 ± 0.8(P<0.001),respectively. Postoperative satisfaction was rated as excellent in 42 cases,good in 3 cases,and fair in 1,with a good-toexcellent rate of 97.8%. The physical examinations at 6 and 12 months postoperatively were of negative results in the anterior drawer and Lachman tests,while the average return-to-sports time was 8.3± 2.5 months. All patients had primary healing of the avulsion fractures without any postoperative complications such as infection,joint stiffness,displacement or loosening of the fracture block,or malunion,and none required secondary surgery. Conclusion The arthroscopic“Three Suture-Trident Star”technique demonstrates significant clinical efficacy in treating patients with avulsion fractures of the ACL distal point,effectively restoring postoperative joint stability an

关 键 词：前交叉韧带下止点 撕脱骨折 关节镜 缝线骨道技术 

分 类 号：R687.4[医药卫生—骨科学]