关节镜下掌骨钢板结合不可吸收缝线固定治疗前交叉韧带止点撕脱骨折

Metacarpus plate fixation with suture for tibial insertion avulsion fracture of anterior cruciate ligament under arthroscopy

目的探讨关节镜下掌骨钢板结合不可吸收缝线固定治疗前交叉韧带（ACL）止点撕脱骨折的临床效果。方法对16例有明显移位的ACL止点撕脱骨折在关节镜下进行复位，使用掌骨钢板结合不可吸收Ethieon缝线进行固定。术后进行积极康复训练。结果16例获随访0．5～2．5年，术后所有骨折均获得愈合，无骨折移位出现。术后3个月，无膝关节松弛或者不稳定发生，所有患者膝关节活动度均恢复至伤前水平。末次随访时IKDC主观膝关节功能评分平均（95．1±2．8）分。结论关节镜下利用掌骨钢板和不可吸收缝线固定治疗ACL止点撕脱骨折复位和固定效果好、创伤小，可早期进行膝关节康复训练，能够尽快恢复膝关节功能。

Objective To investigate the clinical effects of the metacarpus plate fixation with suture by arthroscopic technique for treatment of the tibial insertion avulsion fracture of anterior cruciate ligament. Methods Sixteen patients with tibial insertion avulsion fracture of anterior cruciate ligament were treated with arthroscopic reduction, metacarpus plate fixation with Ethicon non-absorbable sutures. Postoperative habilitation was performed. Results Postoperative follow-up of 0.5 to 2.5 years revealed that all the fractures were healed and no replacement appeared. After 3 months of the operation, no relaxation or unstable of knees occurred. The affected sides of patients restored to the same range of motion before injury. Last follow-up showed the scores of IKDC subjective knee evaluation were （95.1±2.8）points. Conclusion It could achieve satisfying reduction, reliable fLxation, small wound and early rehabilitation to treat the tibial insertion avulsion fracture of anterior cruciate ligament by axthmscopic technique of the metacarpus plate fLxation with suture. Therefore this technique could get the early restoration of knee joint function.