关节镜下缝线套扎治疗胫骨髁间嵴撕脱性骨折

Arthroscopic Treatment for Tibial Eminence Avulsion Fracture Using Loop Ligature Fixation

目的探讨关节镜下缝线套扎治疗前交叉韧带胫骨止点处髁间嵴撕脱性骨折的手术方法及其临床疗效。方法自2006年7月～2009年11月,对19例前交叉韧带胫骨止点处髁间嵴撕脱性骨折在关节镜下应用缝线套扎治疗。结果术后随访9～48个月,平均25.7个月。术后3个月X线片查示骨折均愈合。17例前抽屉试验、Lachman试验查体均为阴性,2例前抽屉试验阴性,Lachman试验弱阳性。Lysholm评分:术前平均(51.6±4.5)分,术后平均(92.1±3.2)分(P<0.05),IKDC 2000主观评分术前平均(57.4±4.6)分,术后平均(90.8±3.9)分(P<0.05)。结论关节镜下应用缝线套扎方法治疗前交叉韧带胫骨止点处髁间嵴撕脱性骨折,能够实现骨折块的有效复位、牢固固定以及骨折愈合,是一种成本低廉、操作简便、效果显著的微创治疗方法。

Objective To investigate the outcomes of arthroscopic reduction and intenal fixation of tibial eminence avulsion fracture using loop ligature fLxation. Methods From July 2006 to November 2009, 19 patients （14 males and 5 females） with tibial anterior eminenee avulsion fracture were treated with arthroscopic reduction and fixation using loop ligature in this research. Results The mean follow-up period was 25.7 months （range, 9 to 48 months）.The X-ray indicated that all the avulsion fractures of tibial anterior eminence were healed after 3 months of the operation. Lachaman test and anterior drawer test were both negative in 17 cases. Weakly positive Lachman test and negative anterior drawer test were found in 2 cases. The mean Lysholm score improved from 51.6±4.5 preoperatively to 92.1±3.2 postoperatively （P 〈0.05）.The mean IKDC 2000 subject score improved from 57.4±4.6 preoperatively to 90.8±3.9 postoperatively （P 〈0.05）. Conelusion Arthroscopic treatment using loop ligature fixation for tibial eminence avulsion fracture could provide satisfying reduction, stable fixation and well healing of the avulsed fragment. This arthroscopic suture fixation method is a minimally invasive, simple and effective treatment for patients with tibial eminence fracture.