膝后内侧入路金属空心螺钉治疗后交叉韧带胫骨止点撕脱骨折的疗效分析

Cannulated screw fixation through posteromedial approach screw for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament

目的：探讨膝后内侧入路金属空心螺钉治疗后交叉韧带胫骨止点撕脱骨折的疗效.方法：自2007年2月至2012年3月共收治36例后交叉韧带胫骨止点撕脱骨折患者,男28例,女8例;年龄16～57岁,平均35岁.均为新鲜闭合性骨折,屈膝90°位后抽屉试验阳性,后沉征阳性.患者均摄膝关节X线片,发现胫骨平台后侧有撕脱骨块,均取膝后内侧入路,用金属空心螺钉固定,术后指导功能锻炼.采用Lysholm膝关节功能评分评价疗效.结果：所有病例成功完成手术,并获随访,时间6～36个月,平均12个月.术后3个月骨折部位均愈合.根据Lysholm膝关节评价标准,优30例,良4例,可2例,平均（92.2±3.8）分.结论：膝后内侧入路金属空心螺钉治疗后交叉韧带胫骨止点撕脱骨折能较大限度恢复关节功能,是一种安全、简单、有效的手术方法.

Objective：To explore therapeutic effects of cannulated screw fixation through posteromedial approach for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament.Methods：From February 2007 to March 2012,36 patients with tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament were reviewed.Among the patients,28 patients were male and 8 patients were female,ranging in age from 16 to 57 years old,averaged 35 years old.All fractures were fre sh closed fracture.The posterior drawer test and heavy sign were positive in all patients.AP X-ray of knee joints of all patients showed avulsion fracture flaps at the posterior tibia platform.All the patients were treated with cannulated screw fixation through posteromedial approach,and function exercise performed after operation.The Lysholm criterion was used to evaluate clinical effects.Results：All the patients had successful operation,and were followed up.The duration of follow-up ranged from 6 to 36 months,with an average of 12 months.The fractures healed at 3 months after operation.According to Lysholm knee joint evaluation criteria,30 patients got an excellent result,4 good and 2 poor,the average score was 92.2 ±3.8.Conclusion：Cannulated screw fixation through posteromedial approach for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament is effective to recover joint function to large extent,which is a safe,simple and effective surgical method.