关节镜下可降解缝线锚钉3点法固定胫骨髁间嵴骨折的疗效评价

Evaluation of three-point fixation of tibial eminence fracture with absorbable suture screw under arthroscope

目的探讨关节镜下使用可降解缝线锚钉固定3点法固定胫骨髁间嵴骨折的临床疗效。方法选择关节镜下缝线锚钉3点法固定前交叉韧带(ACL)止点胫骨止点撕脱骨折患者19例,其中男性12例,女性7例;年龄18~55岁,平均年龄36.47岁。手术前后行前抽屉试验及Lachman试验评估患侧膝关节稳定性;术后采用测量关节活动度、国际膝关节文献委员会(IKDC)评分及Lysholm评分评估膝关节功能情况。随访时对健侧膝关节同时行测量关节活动度、Lysholm功能评分及IKDC评分作为患侧膝关节功能恢复情况的对照。结果所有患者X射线片显示骨折均在术后3个月愈合,无再次骨折移位,患膝查体前抽屉试验及Lachman试验均阴性;患膝术后6个月随访时关节活动度、Lysholm评分及IKDC评分与健侧比较,差异无统计学意义(t=1.53、0.78、0.91,P>0.05、>0.05、>0.05),患膝术后6个月随访时关节活动度、Lysholm评分及IKDC评分与术前比较,差异均有统计学意义(t=-18.91、-23.12、-41.11,P<0.05、<0.05、<0.05)。结论关节镜下可降解缝线锚钉3点法固定胫骨髁间嵴骨折具有创伤小、固定可靠的优点,关节功能恢复好,临床疗效满意。

Objective To investigate the clinical effect of 3-point fixation with absorbable suture screw under arthroscope in patient with tibial spine avulsion fracture. Methods From January 2019 to September 2021, a total of 19 cases patients with tibial avulsion fracture of anterior cruciate ligament(ACL) who performed arthroscopic suture anchor 3-point fixation were enrolled, which included 12 males and 7 females, aged 18-55 years old with mean age of 36.47 years old. The stability of affected knee joint before and after operation was evaluated by anterior drawer test and Lachman test. The knee joint function post operation was evaluated by measuring range of motion, International Knee Documentation Committee(IKDC)score and Lysholm score. During follow-up, the range of motion, Lysholm function score and IKDC score of healthy knee joint were measured at the same time to probe knee joint function recovery of affected side. Results The X-ray images of all patients showed that the fractures healed 3-month post operation, and without refracture displacement, the anterior drawer test and Lachman test were negative. There was no significant difference in joint mobility, Lysholm score and IKDC score between affected knee and healthy side 6-month post operation(t = 1.53, 0.78, 0.91, all P > 0.05, > 0.05, > 0.05). There were significant differences in range of motion, Lysholm score and IKDC score between before and 6-month post operation(t =-18.91,-23.12,-41.11, P < 0.05, <0.05, < 0.05). Conclusion It is demonstrated that the advantages of arthroscopic absorbable suture anchor 3-point method for fixation of tibial intercondylar eminence fracture have small trauma, reliable fixation, good joint function recovery and satisfactory clinical efficacy.