15例胫骨平台骨折合并前交叉韧带断裂的治疗体会

The experience of the treatment for 15 cases of tibial plateau fracture with anterior cruciate ligament rupture

目的探讨胫骨平台骨折合并前交叉韧带断裂的治疗方法。方法15例胫骨平台骨折患者，于术前行膝关节稳定试验及MRI检查，明确前交叉韧带损伤情况，撕裂或撕脱韧带于骨折手术时修复而断裂韧带于骨折愈合后（4～8个月）行关节镜下韧带重建术。结果15例患者骨折均愈合，拆除内固定物同时行关节镜下韧带重建术。术后经12～24个月随访：出现1例韧带松弛，其余患者膝关节稳定性良好，抽屉试验阴性，未见创伤性关节炎发生。结论对胫骨平台骨折合并前交叉韧带断裂患者在骨折愈合后于关节镜下行韧带修复术，关节功能恢复良好。

Objective To explore the treatment of the tibial plateau fracture with anterior cruciate ligament rupture. Methods 15 cases of tibial plateau fracture had a knee stability test and MRI examination before operation. Torn or avulsed ligament was repaired during fracture surgery, while ruptured ligament was reconstructed under the guidance of arthroscope after fracture healing （4 -8 months）. Results All 15 patients with fractures were healed, and arthroscope assisted ligament reconstruction was performed when internal fixture was eliminated. During a follow - up period of 12 - 24 months： except 1 cases of ligament laxity, the remaining patients had a good knee stability with negative result of drawer test, and no traumatic arthritis was found. Conclusion Arthoscope assisted ligament repair performed after fracture healing had a good effect on the tibial plateau fi＇acture with anterior cruciate ligament rupture