关节镜下钢丝和不可吸收缝线“8”字固定前交叉韧带胫骨止点骨折疗效分析

Clinical outcomes of arthroscopic '8'shaped fixation of avulsion fractures of the tibial insertion of the anterior cruciate ligament using wire and nonabsorbable sutures

目的:观察关节镜下钢丝和不可吸收缝线"8"字固定前交叉韧带胫骨止点骨折的疗效。方法:对42例前交叉韧带胫骨止点骨折患者在关节镜下应用钢丝(A组)或不可吸收缝线(B组)两种内固定材料作"8"字固定,术后随访,行前抽屉试验(ADT试验)、Lachman试验、轴移试验评价膝关节稳定性,Lysholm评分评价膝关节功能,X线检查评价骨折愈合情况。结果:术后随访6～24个月,平均18个月,42例骨折均获得满意的复位,均完全愈合,膝关节活动度均正常。Lysholm评分两组患者术后与术前比较差异有统计学意义,两组间术后比较差异无统计学意义。结论:关节镜下钢丝和不可吸收缝线"8"字固定前交叉韧带胫骨止点骨折创伤小、操作方便、固定可靠、康复快,但后者更易于操作,且不影响MRI检查、可避免二次手术及减轻患者经济负担。

Objective： To explore the arthroscopic ‘8’ shaped fixation of anterior cruciate ligament tibial avulsion fractures using wire and nonabsorbable sutures.Methods：A retrospective analysis was conducted on 42 patients treated with arthroscopic figure-of-eight fixation of avulsion fractures of the tibial insertion of the anterior cruciate ligament using wire（group A） and nonabsorbable sutures（group B）. Follow-up assessment included anterior drawer test（ADT）,Lachman test,pivot shift,Lysholm knee score and radiological evaluation.Results：The average follow-up period was 18 months, ranging from 6 to 24 months.All 42 cases successfully achieved reduction and bone union.The pre- and post-operative Lysholm knee scores were statistically significant differenet in group A and group B.The post-operative Lysholm knee scores were not statistically significant differenet between group A and group B.Conclusion： Arthroscopic ＇8’shaped fixation of avulsion fractures of the tibial insertion of the anterior cruciate ligament using wire and nonabsorbable sutures is minimally invasive,convenient,reliable for fracture reduction and early rehabilitation.But nonabsorbable suture is easy to operate,possible to the MRI and it does not require a second operation to remove the hardware and reduces economic burden.