改良膝后路小切口配合关节镜治疗后交叉韧带胫骨止点撕脱骨折42例疗效观察

Modified Small Incision Behind Knee to Match Arthroscopy for Tibial Avulsion Fracture of Posterior Cruciate Ligament

目的:探讨后交叉韧带胫骨止点撕脱骨折的一种新的手术治疗方法.方法:2002年8月至2005年1月共治疗42例后交叉韧带胫骨止点撕脱骨折的患者,先行关节镜检,处理关节内的合并伤,然后通过改良膝后路小切口切开复位并用带垫片空心松质骨拉力螺钉内固定.结果:42例均得到随访,时间4～30个月,平均16.5个月.疗效采用童松林等标准评定,优40例,良1例,可1例,差0例, 优良率为 97.62%.所有病例术后3个月均获正常范围活动.结论:本术式为后交叉韧带胫骨止点撕脱骨折提供了一种新的手术方法,简便易行,便于推广应用.

Objective： To explore a new way of operative treatment for tibial avulsion fracture of posterior cruciate ligament. Methods： 42 cases with tibial avulsion fracture of posterior cruciate ligamen were treated from August 2002 to January 2005. At first dealed with intraarticular additional injuries after arthroscopy . The fracture fragment was fixed with cannulated cancellous screw and washer after debridement and reduction by using modified small incision behind knee. Results： All patients were followed up. Followed - up time ranged from 4 to 30 months （ average, 16.5 months）. The knee function excellent were 40 cases, better was 1 case, fair 1 case according to Tong＇s evaluation standard. The excellent and good rate was 97.62%. All patients gained normal range of motion of knee joint in three months postoperatively. Conclusion：This procedure is a new operative manner for treating tibial avulsion fracture of posterior cruciate ligament. It is easy to spread and operate.