摘要
目的探讨关节镜下钢丝解剖固定治疗儿童前交叉韧带(ACL)胫骨止点撕脱骨折的手术方法和临床疗效。方法选择2008年9月至2012年9月潍坊医学院附属益都中心医院收治并采用关节镜下钢丝固定治疗儿童前交叉韧带胫骨止点撕脱骨折13例,采用钢丝对前交叉韧带前内侧束止点和后外侧束止点均进行固定,达到解剖内固定。并通过术前及术后随访一般情况、Lachman试验及前抽屉试验,并采用Lysholm评分表进行膝关节功能的评估和疗效分析。结果术前13例患者Lachman试验、前抽屉试验均为阳性,术后末次随访均为阴性。术前及术后末次随访,Lysholm评分由术前的(46.9±2.7)分提高到(94.7±1.8)分,差异有统计学意义(P<0.05)。结论关节镜辅助下钢丝解剖固定治疗儿童前交叉韧带胫骨止点撕脱骨折,具有创伤小、能够有效恢复膝关节的前后向及旋转稳定性,更接近于ACL胫骨止点的解剖生物力学重建,固定牢固,可早期行关节功能锻炼,并发症少等优点,疗效满意。
Objective To investigate the operation methods and clinical effect of anatomic fixation under athroscopy for pedi-atric anterior cruciate ligament（ ACL）tibial avulsion fractures using Kirschner wires. Methods From Sep 2008 to Sep 2012,13 pediatric patients with isolated ACL tibial avulsion fractures underwent anatomic fixation under athroscopy treated at our institution were selected. Both tibial insertion of ACL anteromedial bundle and posterolateral bundle were fixed. The clinical examination, Lachman test,anterior drawer test was followed-up,the knee-joint function was evaluated with Lysholm score,and the effects were analyzed. Results The results of preoperative Lachman test,anterior drawer test were all positive. At the last follow-up, the results became negative. The preoperative and postoperative Lysholm score rised from（46. 9 ± 2. 7）to（94. 7 ± 1. 8）. There was significant difference in the Lysholm score between preoperation and postoperation（P﹤0. 05）. Conclusion Athroscopy as-sisted anatomic fixation for pediatric anterior cruciate ligament（ ACL）tibial avulsion fractures using Kirschner wires,can effec-tively recover the stability and knee function,more close to the anatomical biomechanical tibial insertion of ACL. It also has the advantages of little trauma,firm fixation,early rehabilitation and little complications,and the effect is satisfactory.
出处
《临床医学》
CAS
2014年第7期24-26,共3页
Clinical Medicine
关键词
关节镜
胫骨止点撕脱骨折
前交叉韧带
解剖固定
钢丝
Arthroscopy
Tibial avulsion fracture
Anterior cruciate ligament
Anatomic fixation
Kirschner wires
