关节镜下空心加压螺钉内固定治疗前交叉韧带胫骨止点撕脱骨折27例分析

Analysis of Arthroscopic Internal Fixation by Cannulated Compression Screw in Treatment of 27 Cases with Avulsion Fracture of Tibial Insertion of Anterior Cruciate Ligament

目的探讨关节镜下空心加压螺钉内固定治疗前交叉韧带胫骨止点撕脱骨折的手术方法及疗效。方法 2012年1月—2015年3月期间,运用关节镜技术复位并予空心加压螺钉固定前交叉韧带胫骨止点撕脱骨折27例,术后配合功能锻炼,所有患者行影像学检查判定骨折愈合情况,进行疗效评定,于术后8~15个月再次行关节镜手术取出内固定螺钉。结果术后影像学及取内固定时关节镜下检查：所有骨折均解剖复位,骨性愈合,无髁间窝撞击,膝关节活动度正常26例,1例屈曲稍受限但超过90°,所有患者前交叉韧带张力正常,Lachman试验及抽屉试验阴性,无其他并发症发生。结论关节镜下空心加压螺钉内固定治疗前交叉韧带胫骨止点撕脱骨折,手术操作简单,固定牢固,创伤小,术后恢复快,并发症少,是该类骨折手术治疗的优选方式,取得了良好的临床效果。

Objective To discuss the operative method and curative effect of arthroscopic internal fixation by cannulated compression screw in treatment of 27 cases with avulsion fracture of tibial insertion of anterior cruciate ligament. Methods 27 cases with avulsion fracture of tibial insertioJa.of anterior eruciate ligament were treated with arthroscopic reduction and internal fixation by cannulated compression screw ,and were with functional exercise after operation, the fracture healing condition of patients was determined by imaging examination and the curative effect was evaluated, and they were given arthroscopic operation again to take out internal fixation screw in 8-15 months after operation. Results All fractures were anatomic reduction with bone healing and no condyle fossa impact, normal knee joint activity was 26 cases, buckling slightly restricted but more than 90° was 1 case, anterior cruciate ligament tension of all patients was normal, Lachman test and drawer test of all patients was negative, and there was no the other complications. Conclusion Arthroscopic internal fixation by cannulated compression screw in treatment of avulsion fracture of tibial insertion of anterior cruciate ligament is with easy operative procedures, firm fixation, small trauma, quick recovery and few complications, which is the preferred method for the treatment of this type of fracture and obtains a good clinical effect.