微创治疗前交叉韧带胫骨止点撕脱性骨折的预后分析

Analysis of prognosis of minimally invasive treatment on anterior cruciate ligament tibial insertion avulsion fracture

目的探讨关节镜辅助下治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的临床效果。方法回顾性分析在关节镜辅助下"8"字缝线法治疗的前ACL胫骨止点撕脱性骨折患者37例的临床资料。结果术后1年患者的膝关节Rasmussen功能评价中主观评价部分,患者术后的疼痛6分、行走能力、关节稳定性、伸膝关节、膝关节活动度、总分均较术前显著的提高且差异具有统计学意义(P<0.05);放射学评价部分中,髁部变宽、成角畸形、总分均较术前显著的提高且差异具有统计学意义(P<0.05)。采用HSS评价系统对患者术后1年的膝关节功能进行评价:优22例、良9例、中6例、差0例,优良率为83.78%(31/37)。结论关节镜辅助下治疗前交叉韧带胫骨止点撕脱性骨折具有复位、固定可靠,术后患者膝关节功能恢复良好的优点。

Objective To investigate the clinical effect of arthroscopic treatment on anterior cruciate ligament （ACL） tibial insertion avulsion fracture. MethodsThe clinical data of 37 patients with ACL tibial avulsion fracture underwent arthroscopically assisted treatment of “8” suture method were analyzed retrospectively.ResultsAfter one year,in the subjective evaluation part of Rasmussen functional assessment, patients with 6 scores of postoperative pain, walking ability, joint stability, extension of the knee joint and knee joint activity, total score increased obviously compared with those before operation, and the difference was statistically significant （P〈0.05）; In the part of radiologic evaluation, condylar variable width, angular deformity and total scores increased obviously compared with those before operation, and the difference was statistically significant （P〈0.05）. After one year, the evaluation of knee joint function was evaluated by HSS system： excellent in 22 cases, good in 9 cases, median in 6 cases, poor in 0 cases, the rate of excellent and good was 83.78% （31/37）. ConclusionIt has the advantages of reliable fixation, well recovered of knee joint function on the treatment of anterior cruciate ligament tibial insertion avulsion fractureunder the assist of arthroscope.