溢水法和碰击法判定重建前交叉韧带中Rigidfix股骨端横穿钉固定隧道准确性对照研究

Comparison of Accurate Cross Pin Positioning of Fluid Outflow Method and Metal-to-metal Touch Feeling Method with Rigidfix Femoral Fixation in Anterior Cruciate Ligament Reconstruction

目的探讨溢水法和碰击法判定重建前交叉韧带(ACL)中Rigidfix股骨端可吸收横穿钉固定隧道的准确性。方法对40例ACL损伤患者行关节镜下ACL重建术。采用双监视法解剖等长重建技术建立股骨胫骨隧道。股骨端用Rigidfix股骨端可吸收横穿钉固定,胫骨端用Intrafix固定。术中比较股骨端溢水法、导针碰击法判定用于可吸收横穿钉固定的隧道是否位于股骨隧道中央的准确性。结果 40例股骨端外侧套管均有溢水,导针碰击法34例出现金属碰击感,6例无金属碰击感。用关节镜判定,其中导针碰击法中34例出现金属碰击感者,横穿钉固定隧道均在中央,无金属碰击感的6例均偏向一侧。2种方法经χ2检验比较,差异有统计学意义(χ2=6.49,P<0.05)。结论导针碰击法判定可吸收横穿钉固定隧道,操作简便,判定可靠,值得推广应用。

Objective To compare the accurate cross pin positioning of fluid outflow method and metal-to-metal touch feeling method with Rigidfix femoral fixation in anterior cruciate ligament（ACL） reconstruction.Methods Arthroscopic ACL reconstruction was carried out in 40 patients with ACL injuries by using the quadruple hamstring tendon autograft.Forty patients used two-stakeout anatomy isometric technique to prepared method of the bone tunnels of the femur and the tibia.Quadruple hamstring tendon were fixed with femoral Rigidfix fixation and tibia Intrafix fixation.We compared the accurate cross pin positioning of fluid outflow method and metal-to-metal touch feeling method with Rigidfix femoral fixation in ACL reconstruction during the operation.Results All of 40 patients had fluid outflow through sleeves in the femoral cross pin tunnel.In the same patients,34 patients had the metal-to-metal touch feeling and accurate pinhole placement were verified accurate by direct vision of the femoral tunnel with the arthroscope,and 6 patients did not have the metal-to-metal touch feeling and inaccurate pinhole placement were verified by direct vision of the femoral tunnel with the arthroscope.There were significant difference in the accurately between fluid outflow method and metal-to-metal touch feeling method（χ^2=6.49,P 〈0.05）.Conclusion Metal-to-metal touch feeling method can be simple,reliable,useful,and not time consuming in detecting accurate cross pin positioning.