关节镜下双束缝线固定治疗后交叉韧带胫骨止点撕脱骨折

Arthroscopic suture fixation for avulsionractures in the tibial attachment of the posterior cruciate ligament

目的探讨关节镜下双束缝线固定治疗后交叉韧带胫骨止点撕脱骨折的方法及疗效。方法采用关节镜下双束缝线固定治疗后交叉韧带胫骨止点撕脱骨19例。结果 19例术后平均随访16.8个月(12～26个月),X线片显示所有骨折均完全愈合,仅1例患者残留后抽屉试验阳性,3个月时关节活动度基本恢复正常。末次随访膝关节Lysholm评分为92.1分(91～96分)。结论关节镜下双束缝线固定治疗后交叉韧带胫骨止点撕脱骨折是一种简便、安全、微创、可靠的方法,疗效确切。

Objective To highlight our surgical technique of arthroscopic double bundle suture fixation for tibial eminence posterior cruciate ligament avulsion fractures,clinical and radiographic outcomes,and complication rates.Methods This prospective study enrolled 19 patients who had undergone arthroscopic reduction and suture fixation by use of 4 No.5 Ethibond sutures for image-proven displaced PCL attachment fractures of the tibial eminence with posterior knee instability.Results The mean follow-up period was 16.8 months（range 12 to 26 months）.All 19 fractures achieved union within 3 months.The mean postoperative Lysholm score was 92.1（range,91 to 96）.No significant complications such as arthrofibrosis,loss of initial fixation,or wound infection were noted.Conclusion Treatment of tibial PCL avulsion fractures by arthroscopic double bundle suture fixation is a successful technique to restore tibial avulsion injuries of the PCL with well-documented radiographic healing,good clinical outcomes,and low complication rates.