摘要
目的探讨关节镜下缝线"8"字打结、空心钉固定治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的可行性及近期疗效。方法对15例ACL胫骨止点撕脱性骨折行关节镜下ACL胫骨止点缝合及空心钉固定术,采用在关节镜下结合常规关节镜入路和经髌腱入路进行骨折复位固定,术中使用双根5号Ethibond聚乙烯缝线,在韧带下方、骨块上方经前内侧入路从后往前拢住韧带,并打结呈"8"字形,经韧带两侧胫骨骨隧道拉到胫骨内下方。在骨隧道下方2cm处打入带垫圈的直径4.5mm空心钉,做后抽屉试验,同时拉紧固定线,复位骨块,将固定线固定于空心钉垫圈下,拧紧空心钉。结果手术时间40～60min,平均50min。15例随访6～18个月,平均12个月。术后6周,所有骨折均获愈合,未出现移位。术后3个月,1例有Ⅰ度前抽屉试验阳性,其余患者均为阴性。所有患者屈伸膝活动度正常。术后半年Lysholm膝关节功能评分90～96分。结论关节镜下缝线"8"字打结空心钉固定治疗ACL胫骨止点撕脱性骨折,术中关节镜监控可靠,操作简便,效果满意,值得推广。
Objective To study the feasibility and short- term effects of arthroscopic figure- of- 8 suture fixation with cannulated screw and washer for bony avulsion of the anterior cruciate ligament. Methods Arthroscopic figure - of - 8 suture fixation with cannulated screw and washer was carried out in 15 patients with bony avulsion of the anterior cruciate ligament. There were treated arthroscopically through routine portal and through patellae ligament portal. The anterior cruciate ligament and avulsion bone fragment were held figure - of- 8 together with 2 Ethibond 5 polyester threads, which were first wrapped around the anterior cruciate ligament from posterior to anterior through routine anterior- medial portal and patellae ligament portal. The threads were pulled out through tibia tunnels and tightened and fixed on cannulated screw and washer 2 cm under tibia tunnels. Results The operation time were 40-- 60min. A follow up was made in the 15 patients for 6--18 months. All fractures were united without displacement 6 weeks after operation. No knee instability was detected 3 months postoperatively, except for 1 patient with I degree of positive anterior drawer test. Knee flexion and extension function was normal. No postoperative complications occurred. The Lysholm scores were 90--96. Conclusion Arthroscopic figure - of- 8 suture fixation with cannulated screw and washer for bony avulsion of the posterior eruciate ligament technique is simple to perform and has a satisfactory short - term result.
出处
《中国骨与关节损伤杂志》
2009年第2期115-117,共3页
Chinese Journal of Bone and Joint Injury
关键词
关节镜
前交叉韧带
膝关节
骨折
Arthroscopy
Anterior cruciate ligament
Knee joint
Fracture
