关节镜下单骨道双Endobutton固定治疗后交叉韧带胫骨止点撕脱骨折22例分析

Arthroscopic single bone tunnel with double Endobuttons fixation for the treatment of tibial posterior cruciate ligament avulsion fracture in 22 cases

目的探讨关节镜下单骨道双Endobutton固定治疗后交叉韧带胫骨止点撕脱骨折的临床疗效。方法2013年1月~2018年1月收治的后交叉韧带胫骨止点撕脱骨折病人22例,采用关节镜下单骨道双Endobutton固定。比较术前和术后CT矢状位骨折块最大位移距离、膝关节松弛度、国际膝关节文献委员会(IKDC)分级、视觉模拟评分(VAS)、Lysholm评分和膝关节屈曲度。结果术后切口均一期愈合,无并发症发生。术后CT矢状位骨折块最大位移距离(1.5±0.6)mm,较术前明显改善(P<0.05)。病人均获随访,术后3个月X线检查提示骨折愈合,终末随访时间为24个月。术后24个月所有病人膝关节松弛度均为阴性,IKDC分级均为A级,均较术前明显改善(P<0.05)。术后24个月时VAS评分为(0.1±0.3)分,Lysholm评分为(96.1±4.3)分,膝关节屈曲度为(129.3±6.4)°,均较术前明显改善(P<0.05)。结论关节镜下单骨道双Endobutton固定治疗后交叉韧带胫骨止点撕脱骨折可改善膝关节术后疼痛,恢复膝关节功能。

Objective To explore the clinical efficacy of arthroscopic single bone tunnel with double endobuttons fixation for the treatment of tibial posterior cruciate ligament avulsion fracture.Methods A retrospective analysis of 22 patients with tibial posterior cruciate ligament avulsion fracture who met the selection criteria between January 2013 to January 2018 were made.Surgery were treated with arthroscopic single bone tunnel with double endobuttons fixation.The preoperative and postoperative maximum displacement of the sagittal CT fracture block,knee laxity,International Knee Documentation Committee(IKDC) grading,Visual Analogue Score(VAS),Lysholm score and the angle of knee flexion were compared.Results All incisions healed by first intention without complications.The maximum displacement of the sagittal CT fracture block was(1.5±0.6)mm after operation,which was significantly improved when compared with that before operation(P<0.05).All patients were followed up,and X-ray showed fracture healed at 3 months after operation,and the last follow-up time was 24 months.All patients showed negative knee laxity and IKDC grade A at 24 months after operation,which was significantly improved when compared with that before operation(P<0.05).VAS score was(0.1±0.3),Lysholm score was(96.1±4.3),and the angle of knee flexion was(129.3±6.4)°at 24 months after operation,which were significantly improved when compared with those before operation(P<0.05).Conclusion Arthroscopic single bone tunnel with double Endobuttons fixation for the treatment of tibial posterior cruciate ligament avulsion fracture can significantly improve postoperative pain and restore knee function.