关节镜下复合可吸收骨铆钉治疗前交叉韧带胫骨止点撕脱性骨折的疗效研究

Arthroscopic Combined Absorbable Bone Rivet for the Treatment of Anterior Cruciate Ligament and Avulsion Fracture of the Humerus

目的探讨对前交叉韧带胫骨止点撕脱性骨折采用关节镜下复合可吸收骨铆钉治疗的疗效。方法方便选择2015年1月—2017年12月期间该院接诊的12例前交叉韧带胫骨止点撕脱性骨折患者为研究对象,均接受关节镜下复合可吸收骨铆钉联合线缆带子治疗,观察其治疗效果。结果 12例患者术后切口均Ⅰ期愈合,无并发症发生;术后即刻经X线片检查骨折恢复良好;术后3个月经X线片检查前交叉韧带胫骨止点撕脱性骨折均为骨性愈合,平均愈合时间为(6.98±0.56)周;1例Lachman试验阴性,前抽屉试验弱阳性,11例患者Lachman试验与前抽屉试验均为阴性;末次随访与术前Lysholm评分分别为(90.01±3.07)分、(42.54±5.79)分,国际膝关节文献委员会膝关节评估表(The international knee documentation committee knee evaluation form,IKDC)分别为(93.48±6.33)分、(43.19±5.28)分,差异有统计学意义(t=27.987、23.678,P<0.05)。结论对前交叉韧带胫骨止点撕脱性骨折患者采用关节镜下复合可吸收骨铆钉联合线缆带子治疗效果显著,手术创伤小,能实现有效复位、牢固固定,术后愈合较快,具有固定准确牢固、简单易行、无需二次手术取内固定等优势,利于临床推广。

Objective To investigate the efficacy of arthroscopic combined absorbable bone rivets in the treatment of avul- sion fractures of the anterior cruciate ligament. Methods 12 patients with anterior cruciate ligament tibiofibular avulsion fractures who underwent surgery in the hospital from January 2015 to December 2017 were convenient selected and enrolled in this study. All patients underwent arthroscopic combined absorbable bone rivets and cable straps to observe its therapeu- tic effect. Results All the 12 patients underwent I-stage healing without complications. The fractures recovered well after X-ray examination. The anterior cruciate ligament and the avulsion fractures of the anterior cruciate ligament were examined by X-ray. Bone healing, mean healing time was （6.98±0.56） weeks; 1 case was negative for Lachman test, weak posi- tive for front drawer test, 11 cases were negative for Lachman test and front drawer test; the last follow-up and preoperative Lysholm score were （90.01±3.07） points, （42.54±5.79） points, the International knee documentation committee knee evalua- tion form （IKDC） was （93.48±6.33） points, （43.19±5.28） points, the difference was statistically significant （t=27.987, 23.678, P〈0.05）. Conclusion The patients with avulsion fractures of the anterior cruciate ligament and the anterior cruciate ligament are treated with arthroscopic combined absorbable bone rivets and cable straps. The surgical trauma is small, can achieveeffective reduction and firm fixation, and heal faster after surgery, accurate and firm, simple and easy, no need for secondary surgery to take internal fixation and other advantages, which is conducive to clinical promotion.