关节镜下TightRope治疗后交叉韧带撕脱骨折

Arthroscopic treatment posterior cruciate ligament avulsion fracture with TightRope

目的探讨关节镜下使用TightRope治疗后交叉韧带(PCL)撕脱骨折的技术应用和临床疗效.方法 12例膝关节PCL撕脱骨折患者在关节镜下使用TightRope固定PCL撕脱骨块.术后1周开始在支具保护下被动活动膝关节,术后10个月评估膝关节功能恢复情况.结果 12例患者均获随访,时间10~14个月,平均12.6个月,骨折均Ⅰ期愈合.1例屈膝受限15°,无伸膝受限;2例后抽屉试验(+).Lysholm膝关节功能评分术前(45.6±6.3)分,术后10个月(87.8±4.8)分,差异有统计学意义(P<0.05).结论关节镜下使用TightRope治疗PCL撕脱骨折固定可靠,操作相对简单,疗效满意.

Objective To introduce an innovative arthroscopic technique using a suspensory device and the treatment outcome of arthroscopic treatment of posterior cruciate ligament avulsion fractures with TightRope. Methods 12 patients with posterior cruciate ligament avulsion fractures were operated under arthroscopy with TightRope. The functional exercise was started after one week postoperatively with a knee extension brace. The total knee function was evaluated with Lysholm scale after 10 months postoperatively. Results All these cases were followed up for an average 12.6 months (range, 10 ~ 14 months) and had primary healing after fracture fixation. At 10 months postoperatively there was no extension limitation. Except for one patient who had 15° flexion limitation. 2 patients were found with the posterior drawer test (+). The Lysholm knee score were (45.6 ± 6.3) before operation and (87.8 ± 4.8) after 10 months postoperatively. There was significant difference between preoperative and postoperative (P < 0.05). Conclusion The method of arthroscopic treatment of posterior cruciate ligament avulsion fracture with TightRope enables strong fixation with minimal dissection, and is simple to operate. Treatment outcomes using TightRope in the fixation of posterior cruciate ligament avulsion fractures are encouraging.