关节镜下Ethibond缝线联合Nice结技术治疗胫骨髁间棘Ⅲ~Ⅵ型骨折

Arthroscopic Ethibond Suture Combined with Nice Knot Technique for the Treatment of Tibial Intercondylar Spine Type Ⅲ ~ Ⅵ Fractures

目的:探讨关节镜下骨折块撬拨复位、Ethibond缝线联合Nice结技术治疗胫骨髁间棘Ⅲ~Ⅵ型骨折的临床疗效及优势。方法:于2014年5月—2018年3月对31例前交叉韧带(ACL)胫骨止点撕脱骨折患者采用关节镜下骨折块撬拨复位、Ethibond缝线环绕ACL基底部经胫骨隧道外口进行Nice结拉紧固定骨折块。术前骨折块按改良Meyers-McKeever分型。记录患者术前、术后3个月临床症状、体征、X-ray、Lysholm评分及IKDC评分。结果:31例术后患者均获随访,随访时间9~18个月,平均15.3个月。术后3个月复查X-ray线示骨折均已愈合。术后3个月Lysholm评分、IKDC评分与术前相比差异具有统计学意义(P<0.01)。结论:关节镜下骨折块复位、Ethibond缝线联合Nice结技术固定治疗胫骨髁间棘Ⅲ~Ⅵ型骨折,有利于骨折块与骨床解剖复位,对恢复膝关节生理功能具有重要意义。

Objective:To investigate the clinical effect and advantages of arthroscopic fracture block pry reduction, Ethibond suture combined with Nice knot technique in the treatment of tibial intercondylar spine type Ⅲ~Ⅵ fractures.Methods:From May 2014 to March 2018, 31 patients with anterior cruciate ligament tibial avulsion fractures were treated with arthroscopic fracture block pry reduction and Ethibond sutures were used to surround the base of the ACL through the tibial tunnel. The outer mouth was tightened with a Nice knot to fix the fracture block.Preoperative fractures were classified according to the modified Meyers-McKeever classification.The clinical symptoms, signs, X-ray, Lysholm score and IKDC score of the patients before and 3 months after surgery were recorded.Results:All 31 patients were followed up for 9 to 18 months, with an average of 15.3 months.X-ray review at 3 months after surgery showed that the fractures had healed.At 3 months after surgery, Lysholm score, IKDC score was statistically different from that preoperative(P<0.01).Conclusion:Arthroscopic fracture reduction, Ethibond suture combined with Nice knot technique for the treatment of tibial intercondylar spine typeⅢtoⅥ fractures are conducive to anatomical reduction of the fracture block and the bone bed, and have important significance for restoring the physiological function of the knee joint.