涉及前后交叉韧带胫骨止点骨折的治疗研究

发布时间：2018-12-19 19:55

【摘要】：目的探讨关节镜联合后路直视下一期空心钉固定治疗膝关节前、后交叉韧带止点撕脱骨折的临床疗效。方法回顾性分析2010年1月至2015年6月该院收治的25例前、后交叉韧带胫骨止点均骨折患者的临床资料。患者均首先平卧位下行关节镜探查是否存在合并伤,确定骨折块及交叉韧带损伤情况,前交叉韧带止点骨折直接在关节镜下复位,并予以空心拉力螺钉内固定;改俯卧位,直视下切开复位后交叉韧带胫骨止点骨折,并予以空心拉力螺钉固定。术后予以下肢可调节矫形支具制动4~6周。选择国际膝关节评分委员会(IKDC)评分进行膝关节功能主观评价,选择Lysholm评分进行膝关节功能客观评价,骨折愈合情况选择X线片或CT评价。结果 25例患者均获得随访,随访时间6~24个月,中位随访时间为15个月;术后骨折均一期愈合,骨愈合时间9~24周,中位骨愈合时间为12周。末次随访时IKDC评分:跛行(4.88±0.29)分,支撑(4.65±0.36)分,疼痛(4.78±0.49)分,肿胀(4.88±0.52)分,下蹲(4.85±0.35)分,均高于术前,差异均有统计学意义(P0.05)。末次随访时患侧Lysholm膝关节功能评分为(93.4±2.8)分,优良率为96.0%,与健侧比较差异均无统计学意义(P0.05)。结论关节镜辅助下应用空心拉力螺钉固定治疗前交叉韧带胫骨止点骨折及应用后内侧入路小切口切开复位空心拉力螺钉固定后交叉韧带胫骨止点骨折具有操作简便、固定可靠、近期疗效满意等优点。
[Abstract]:Objective to investigate the clinical effect of arthroscopic and posterior direct vision first stage hollow nail fixation in the treatment of anterior and posterior cruciate ligament avulsion fractures. Methods from January 2010 to June 2015, 25 patients with anterior and posterior cruciate ligament tibial fractures were retrospectively analyzed. All the patients were examined by arthroscopy in supine position to determine the injury of the fracture and cruciate ligament. The anterior cruciate ligament (ACL) fracture was directly reduced under arthroscopy and the internal fixation of hollow pull screw was performed. Open reduction of tibial fracture of posterior cruciate ligament and fixation with hollow pull screw. The lower extremity adjustable orthopedic brace was used for 6 weeks after operation. The (IKDC) score of the International knee Joint scoring Committee was selected for subjective evaluation of knee joint function, the Lysholm score for objective evaluation of knee joint function, and the X-ray or CT evaluation for fracture healing. Results all the 25 patients were followed up for 6 ~ 24 months, the median follow-up time was 15 months, the bone union time was 924 weeks and the median bone union time was 12 weeks. At the last follow-up, the scores of claudication (4.88 卤0.29), support (4.65 卤0.36), pain (4.78 卤0.49), swelling (4.88 卤0.52), squat (4.85 卤0.35) were higher than those before operation. The difference was statistically significant (P0.05). At the last follow-up, the score of knee joint function of the affected side was (93.4 卤2.8), the excellent and good rate was 96.0 and there was no significant difference between the affected side and the healthy side (P0.05). Conclusion the treatment of anterior cruciate ligament tibial insertion fracture with hollow pull screw assisted by arthroscopy and open reduction of posterior cruciate ligament tibial insertion fracture with small incision through posterior medial approach are simple and reliable. The short-term curative effect is satisfactory and so on.
【作者单位】：安徽省合肥市第二人民医院骨科;
【分类号】：R687.3

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