摘要
目的 探讨关节镜下半月板缝合针引导钢丝内固定治疗前交叉韧带（anterior cruciate ligament,ACL）胫骨嵴撕脱骨折的疗效。方法 1999年12月～2005年8月关节镜下应用半月板缝合针引导钢丝内固定治疗ACL胫骨嵴撕脱骨折15例。采用膝关节Lysholm评分对关节镜手术前、后关节功能进行评价,术后定期复查膝关节正侧位X线片。结果 手术操作均在30min以内完成,无关节感染、意外损伤、关节粘连、骨折不愈合并发症发生。15例随访6～54个月,（20.9±15.0）月,复查X线片显示15例骨折愈合良好。术前Lysholm评分10～56分,（19.1±15.2）分,手术后提高至91～100分,（97.5±3.7）分（t=18.483,P=0.000）。2例术后8、14个月出现内固定钢丝断裂,但骨折愈合良好。结论 关节镜下半月板缝合针引导钢丝固定治疗ACL胫骨嵴撕脱骨折,方法简便、适用范围广、创伤小、术后功能恢复满意。
Objective To investigate the technique and efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament （ACL） from the tibial eminence with stainless steel wire guided by meniscal stitching needle. Methods Fifteen cases of avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle from December 1999 to August 2005. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments. Results The operation was completed within 30 min. No complications of intraartieular infection, iatregenie injury, fibroarthritis, or non-union of fracture were found. The 15 cases were followed for 6 - 54 months （ mean, 20.9 ±15. 0 months）. X-ray films revealed good bone union in all the 15 cases. The Lysholm scores were improved from 19.1 ± 15.2 （range, 10 - 56） preoperatively to 97.5 ± 3.7 （ range, 91 - 100） postoperatively, with significant statistical difference by the student-t test （t = 18. 483 ,P = 0. 000）. Wire breakage was found in 2 cases at 8 and 14 months after operation, respectively. But the bone union in the 2 cases was not affected. Conclusions Arthroscopic internal fixation with stainless steel wire guided by meniscal stitching needle in the treatment of avulsion fracture of the anterior cruciate ligament from the tibial eminence has advantages of simplicity, broad indications （from type Ⅱ to Ⅳ injuries）, minimal invasion, and rapid postoperative recovery.
出处
《中国微创外科杂志》
CSCD
2007年第7期630-631,634,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
半月板缝合针
前交叉韧带
撕脱骨折
关节镜
Meniscal stitching neeedle
Anterior cruciate ligament
Avulsion fracture
Arthroscopy
