摘要
目的观察关节镜下复位经骨隧道缝线固定治疗儿童前交叉韧带(ACL)胫骨止点区撕脱骨折的临床疗效。方法回顾性分析2017年2月—2020年2月中国人民解放军陆军第八十三集团军医院采取关节镜下复位经骨隧道缝线固定技术治疗的ACL胫骨止点区撕脱骨折22例,男性15例,女性7例;年龄6~15岁,平均10.2岁;高处坠落伤5例,运动损伤13例,道路交通伤4例;骨折Meyers-McKeever分型:II型12例,III型7例,IV型3例;伤后至手术时间2~11d,平均6.3d。从复位固定情况、骨折愈合情况以及术后膝关节功能评分等方面评估治疗效果。结果术后随访3~24个月,平均13.6个月。患儿术中均获得满意复位及固定,术后3个月均骨性愈合,无屈伸活动受限,术后1年膝关节无相关并发症发生。术前、术后3个月及术后1年Lysholm评分分别为(33.0±4.4)分、(89.7±2.5)分、(97.6±1.7)分,差异有统计学意义(P<0.05)。结论关节镜下复位经骨隧道缝线固定治疗儿童ACL胫骨止点区撕脱骨折复位好、固定牢靠、功能康复良好,疗效满意,值得推广运用。
Objective To observe the clinical effect of arthroscopic reduction and transosseous suture fixation for the treatment of anterior cruciate ligament(ACL)tibial avulsion fractures in children.Methods From Feb.2017 to Feb.2020,22 cases of avulsion fracture of ACL tibial insertion area treated by arthroscopic reduction and bone tunnel suture fixation in the 83rd Army Hospital of the PLA were retrospectively analyzed,including 15 males and 7 females.Their age ranged from 6 to 15 years,with an average of 10.2 years.There were 5 cases of falling injury,13 cases of sports injury and 4 cases of traffic accident injury;According to Meyers-McKeever classification of fractures,there were 12 cases of type II,7 cases of type III,and 3 cases of type IV fractures.The time from injury to operation was 2-11 days,with an average of 6.3 days.The treatment effect was evaluated from the aspects of reduction and fixation,fracture healing and postoperative knee function score.Results All the 22 cases were satisfactorily reduced and fixed during operation.Bone healing was achieved in 3 months after operation,and there was no limitation of flexion and extension activities.There were no related complications of knee joint at 1 year after operation.The Lysholm scores before operation,3 months after operation,and 1 year after operation were(33.0±4.4)point,(89.7±2.5)points,and(97.6±1.7)points,and the difference was statistically significant(P<0.05).Conclusion Arthroscopic reduction and suture fixation in the treatment of avulsion fracture of ACL tibia insertion area in children has the advantages of small trauma,good reduction,firm fixation,good functional recovery and satisfactory curative effect,which is worthy of wide and application.
作者
赵刚领
孙加伟
张旭辉
郭广惠
马珍珍
黎丹东
Zhao Gangling;Sun Jiawei;Zhang Xuhui;Guo Guanghui;Ma Zhenzhen;Li Dandong(Department of Orthopaedics,Joint Trauma Special Disease Center,the 83rd Army Hospital of the PLA,Xinxiang,Henan 453000,China;91 Unit of 32147 Unit of the 83rd Group Army of the PLA,Baoji,Shaanxi 721000,China)
出处
《创伤外科杂志》
2022年第9期671-674,共4页
Journal of Traumatic Surgery
关键词
胫骨止点区撕脱骨折
前交叉韧带
关节镜
缝线固定
儿童
avulsion fracture of tibia insertion area
anterior cruciate ligament
arthroscopy
suture fixation
children
