关节镜下双缝线Y字型固定前交叉韧带止点撕脱骨折的疗效观察  

Clinical outcome of arthroscopic Y-shaped suture technique for fixation of displaced anterior cruciate ligament avulsion fractures

作　　者：裴杰 王青[2] 郭敦明[2] 宋黄鹤[2] Pei Jie;Wang Qing;Guo Dunming;Song Huanghe(Department of Orthopaedics,Changzhou Traditional Chinese Medicine Hospital,Changzhou,Jiangsu Province213000,China;Jiangsu Province Hospital,Nanjing 210000,China)

机构地区：[1]常州市中医医院,江苏常州213000 [2]江苏省人民医院,南京210000

出　　处：《创伤外科杂志》2024年第10期751-756,共6页Journal of Traumatic Surgery

基　　金：2020南京中医药大学自然科学基金项目(XZR2020041)。

摘　　要：目的探讨关节镜下双缝线Y字型固定前交叉韧带止点撕脱骨折的手术技术及临床疗效。方法回顾性分析2018年1月—2021年12月江苏省人民医院行关节镜下双缝线Y字型固定前交叉韧带止点撕脱骨折患者30例,男性19例,女性11例;年龄27~56岁,平均36.8岁。术后采用VAS及Lysholm评分评定疗效,CT检查评估骨折愈合情况。结果随访18~31个月,平均24.6个月。患者术前VAS(7.3±1.3)分,术后1个月评分较术前降低,以后每个复查时间点(术后6、12个月)较术前均显著减低,末次随访时为(0.5±0.5)分,差异均有统计学意义(P<0.05)。术前Lysholm评分(45.4±7.6)分,术后1个月时(66.3±4.6)分无明显增高,但术后6及12个月时显著增加,分别为(85.1±5.3)分、(92.4±2.4)分,与较术前比较差异有统计学意义(P<0.05)。患者术后12个月复查CT,结果显示均达到骨性愈合。末次随访(12个月后)时,前抽屉试验和Lachman试验均为阴性。结论关节镜下双缝线Y字型固定前交叉韧带止点撕脱骨折,手术技术成熟简便,临床效果显著,是治疗移位前交叉韧带撕脱骨折的有效方法。Objective To investigate the suture technique and clinical effect of double sutures Y-shaped fixation of avulsion fractures of the anterior cruciate ligament(ACL)under arthroscopy.Methods A retrospective analysis was performed on 30 patients with ACL avulsion fractures and fixed with Y-shaped suture technique under arthroscopy in Jiangsu Province Hospital from Jan.2018 to Dec.2021,including 19 males and 11 females aged 27-56(mean 36.8)years.VAS and Lysholm scores were used to evaluate the recovery effects,and CT scans to evaluate the fracture healing.Results Patients were followed up for 18-31(mean 24.6)months.The preoperative VAS was 7.3±1.3 on average,which was significantly decreased at postoperative 1,6,12 months and last follow-up(0.5±0.5,all P<0.05 compared with that before surgery).The Lysholm score was 45.4±7.6 before surgery,which after surgery showed no significant increase at 1 month,but was significantly increased at 6 months(85.1±5.3)and 12 months(92.4±2.4,both P<0.05 compared with that before surgery).CT scan at 12 months after surgery showed bone healing for all patients and negative results for both drawer test and Lachman test.Conclusion Double sutures Y-shaped fixation of ACL avulsion fracture under arthroscopy is simple and very effective,thus can be promoted in clinical practice.

关 键 词：前交叉韧带撕脱骨折 缝线固定 关节镜 

分 类 号：R687.3[医药卫生—骨科学]