双Endobutton悬吊固定青少年患者前交叉韧带胫骨止点撕脱性骨折的早期疗效

发布时间：2018-06-25 10:12

本文选题：关节镜 + 青少年　；参考：《中国运动医学杂志》2017年11期

【摘要】：目的:探讨关节镜下单胫骨隧道,双Endobutton微型钢板结合双股高强度Ultrabraid Suture装置悬吊固定青少年(骨骺未闭合)患者前交叉韧带胫骨止点撕脱性骨折的早期疗效。方法:回顾性分析2012年5月~2015年6月对21例青少年患者急性前交叉韧带胫骨止点撕脱性骨折,采用关节镜下双Endo-button微型钢板结合双股高强度Ultrabraid Suture装置悬吊固定,对所有患者进行关节镜下骨床新鲜化、骨折块复位,双Endobutton微型钢板悬吊固定。所有患者术后1周、1个月、3个月、每隔半年复查X线片。采用前抽屉试验和Lachman试验来评估膝关节术后稳定性,记录Lysholm评分,评估患者术后恢复情况。结果:术中出血量43~68 ml,平均53.95±7.10 ml;手术时间27~55 min,平均38.76±7.71 min。所有21例患者均获随访18~25个月,平均21.86±2.78个月。术后3个月X线片提示骨折块完全愈合,没有出现骨折畸形愈合或不愈合。所有患者均未出现软组织感染、髁间撞击症造成的膝关节伸直受限等并发症。末次随访Lysholm评分(97.14±1.35)相比术前(40.24±5.81)显著提高。结论:关节镜下单胫骨隧道,双Endobutton钢板结合双股高强度Ultrabraid Suture悬吊固定治疗急性期青少年患者前交叉韧带胫骨止点撕脱性骨折,早期临床效果令人满意。
[Abstract]:Objective: to investigate the early effect of single tibial tunnel under arthroscopy, double Endobutton mini-plate combined with double high strength Ultrabraid suture device for suspension fixation of tibial avulsion fracture of anterior cruciate ligament (ACL) in adolescent (epiphyseal unclosed) patients. Methods: from May 2012 to June 2015, 21 cases of acute avulsion fracture of anterior cruciate ligament tibia were analyzed retrospectively. Double Endo-button mini-plate combined with double high strength Ultrabraid support was used for suspension fixation under arthroscopy. All patients were treated with arthroscopic bone bed freshness, fracture block reduction and double Endobutton mini-plate suspension fixation. X-ray examination was performed 1 week, 1 month, 3 months after operation in all patients. Anterior drawer test and Lachman test were used to evaluate the postoperative stability of knee joint, to record the Lysholm score and to evaluate the postoperative recovery. Results: the intraoperative bleeding was 436.68 ml (mean 53.95 卤7.10 ml) and the operative time was 2755 min (mean 38.76 卤7.71 min). All 21 patients were followed up for 18 ~ 25 months (mean 21.86 卤2.78 months). 3 months after operation, X-ray showed complete union of fracture and no malunion or non-union. No soft tissue infection and condylar impingement were found in all patients. Lysholm score (97.14 卤1.35) at the last follow-up was significantly higher than that before operation (40.24 卤5.81). Conclusion: single tibial tunnel under arthroscopy, double Endobutton plate combined with double high strength Ultrabraid suture suspension fixation for tibial avulsion fracture of anterior cruciate ligament in acute juvenile patients, the early clinical effect is satisfactory.
【作者单位】：苏州大学附属第三医院骨关节科;
【基金】：江苏省常州市重大课题(ZD 201604)实用新型专利号:ZL 2015 2 0508727.0
【分类号】：R687.4

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