双Endobutton悬吊固定青少年患者前交叉韧带胫骨止点撕脱性骨折的早期疗效

Double Endobutton Suspension System Fixation for Tibial Insertion Avulsion Fracture of Anterior Cruciate Ligament of Teenagers

目的:探讨关节镜下单胫骨隧道,双Endobutton微型钢板结合双股高强度Ultrabraid Suture装置悬吊固定青少年(骨骺未闭合)患者前交叉韧带胫骨止点撕脱性骨折的早期疗效。方法:回顾性分析2012年5月~2015年6月对21例青少年患者急性前交叉韧带胫骨止点撕脱性骨折,采用关节镜下双Endo-button微型钢板结合双股高强度Ultrabraid Suture装置悬吊固定,对所有患者进行关节镜下骨床新鲜化、骨折块复位,双Endobutton微型钢板悬吊固定。所有患者术后1周、1个月、3个月、每隔半年复查X线片。采用前抽屉试验和Lachman试验来评估膝关节术后稳定性,记录Lysholm评分,评估患者术后恢复情况。结果:术中出血量43~68 ml,平均53.95±7.10 ml;手术时间27~55 min,平均38.76±7.71 min。所有21例患者均获随访18~25个月,平均21.86±2.78个月。术后3个月X线片提示骨折块完全愈合,没有出现骨折畸形愈合或不愈合。所有患者均未出现软组织感染、髁间撞击症造成的膝关节伸直受限等并发症。末次随访Lysholm评分(97.14±1.35)相比术前(40.24±5.81)显著提高。结论:关节镜下单胫骨隧道,双Endobutton钢板结合双股高强度Ultrabraid Suture悬吊固定治疗急性期青少年患者前交叉韧带胫骨止点撕脱性骨折,早期临床效果令人满意。

Objectives To study the early effect of treating teenagers with tibial insertion avulsion fracture of anterior cruciate ligament using the single-tibal tunnel, double Endobutton miniature steel plate combined with twin high-strength Uhrabraid Suture suspension fixation under an anthroscopy. Methods Retrospective analysis was conducted on 21 teenagers with tibial insertion avulsion fracture of anterior cruciate ligament treated between May 2012 and June 2015. They were treated using the single-tibal tunnel, double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation. The X-ray was taken postoperatively at 1 week, 1 month, 3 months and every 6 months. Anterior drawer and Lachman tests were used to evaluate the postoperative stability of knee joints, while the Lysholm score was recorded to assess the postoperative recovery. Results The average total intraoperative blood loss, operation duration and follow-up time were（53.95 ＋ 7.10）ml（ranging from 43 to 68 ml）,（38.76 ~ 7.71）rain（ranging between 27 and 55 min）,and（21.86 _＋ 2.78）months,ranging from 18 to 25 months. All fractures were healed without malunion or nonunion as could be seen in the X-ray taken 3 months after the operation. Moreover, none of the patients suffered from complicationssuch as soft tissue infections or extension lag of the knee joints caused by the femoral intercondylar notch impingement syndrome. The Lysholm score of the last follow-up（97.14 ＋ 1.35）was significantly higher than that before surgery （40.24 ＋ 5.81）. Conclusion The early efficacy of the single-tibal tunnel, double Endonbutton plate combined with twin Uhrabraid Suture suspension system fixation for teenagers with tibial insertion avulsion fracture of anterior cruciate ligament under arthroscopy is satisfactory.