双排锚钉线桥技术固定后交叉韧带胫骨止点撕脱骨折的疗效分析

Curative effects analysis on the surgical treatment for tibial avulsion fracture of the posterior cruciate ligament with double-row suture-bridge technique

[目的]观察应用双排锚钉线桥技术固定治疗膝后交叉韧带胫骨止点撕脱骨折的临床疗效。[方法]对16例膝关节后交叉韧带胫骨止点撕脱骨折的患者，经膝后内侧人路行骨折复位，应用双排锚钉线桥技术固定骨折块，术后3d即开始行膝关节功能锻练。记录手术时间、并发症及骨折愈合情况，记录膝关节屈伸活动度，应用Lysholm膝关节评分系统评估膝关节功能，并对患者健侧膝关节和患膝术后末次随访时的Lysholm评分及关节活动度进行统计学分析。[结果]手术时间45～60min，平均51min。全部切口愈合良好，无神经、血管损伤并发症，无深静脉血栓形成。术后随访6～24个月，平均12个月，所有骨折均一期愈合，膝关节稳定性良好。术后末次随访时患膝的Lysholm评分为89～96分（93．0±2．7）分，关节活动度伸膝-3°～5°（0．5±2．6°），屈膝115°～143°（127．2±9．1°），比较健侧膝关节无统计学差异。[结论]后内侧入路安全、迅速，双排锚钉线桥技术固定强度坚实可靠，配合术后早期功能锻练，应用于膝后交叉韧带胫骨止点撕脱骨折的治疗，可以取得良好的临床疗效。

[ Objective ] To observe the curative effects on the surgical treatment for tibial avulsion fracture of the posterior cruciate ligament with double -row suture -bridge technique. [ Method] The postero -medial approach and technique of double - row suture - bridge was applied for tibial avulsion fracture of the posterior cruciate ligament in 16 cases. The time of surgery, complications and X - ray photographs were analyzed. The range of motion in both side of knee joints was recorded. Post - operative knee joint function and stability were evaluated according to Lysholm scoring scale system. [ Result] Length of surgery ranged from 45 to 60 minutes （51 minutes in average）. All incisions healed well and any vascular or nerve injury or DVT was not found in all cases. All patients were followed from 6 to 24 months （ 12 months in average） and X - rays showed that satisfactory reduction and bony healing was achieved in all cases. The stability of the injured knee joints was good. The post - operative Lysholm score at the last follow - up was 89 - 96 （93.0 ± 2.7） points, and the range of motion of injured knee joints was 0.5° ± 2.6°in extension and 127.2°± 9.1 ° in flexion, which both had no significant difference with that in the other side unin- volved knee joints. [ Conclusion ] The postero - medial approach, with its safe and rapid exposure, and the technique of double - row suture - bridge, with its secure fixation and low probability of complications, may be suitable for the treatment of tibial avulsion fracture of the posterior cruciate ligament and can get good recovery with proper and timely functional exercises.