关节镜下双后内侧入路双骨道单纯“8”字缝线治疗后交叉韧带胫骨止点撕脱骨折的疗效分析

Clinical effect analysis of posterior cruciate ligament avulsion fracture of tibial insertion treated by double posterioral-medial approach with simple 8 suture

目的研究关节镜下双后内侧入路双骨道单纯“8”字缝线治疗后交叉韧带(PCL)胫骨止点撕脱骨折的临床效果。方法选取该院2016年2月-2020年4月PCL胫骨止点撕脱骨折的患者12例,给予关节镜下双后内侧入路双骨道单纯“8”字缝线治疗,对术前和术后末次随访时,膝关节活动范围、国际膝关节文献委员会(IKDC)评分、视觉模拟评分(VAS)、Lysholm膝关节功能评分、反Lachman试验和后抽屉试验进行评价。结果12例患者术中均无副损伤,随访时间为12~24个月,平均(18.92±4.17)个月,术后末次随访时,反Lachman试验阴性,后抽屉试验阴性,膝关节活动度为(128.75±2.26)°,IKDC评分为(82.92±3.34)分,VAS为(1.17±0.39)分,Lysholm膝关节功能评分为(85.00±3.02)分,较术前明显改善,差异均有统计学意义(P<0.05)。结论关节镜下双后内侧入路双骨道单纯“8”字缝线治疗PCL胫骨止点撕脱骨折,临床疗效确切,值得推广。

Objective To investigate the clinical effect of double posterioral-medial approach double bone channel simple 8 suture in treatment of posterior cruciate ligament(PCL)tibial insertion avulsion fracture under arthroscopy.Methods 12 patients with tibial insertion avulsion fracture of PCL from February 2016 to April 2020 were selected and treated with simple 8 suture using double posterioral-medial approach and double bone channel under arthroscopy.Knee range of motion,International Knee Documentation Committee(IKDC)score,visual analogue scale(VAS),Lysholm knee function score,reverse Lachman test,and posterior drawer test were evaluated at preoperative and postoperative follow-up.Results None of the 12 patients had collateral damage during the operation.The follow-up time of the patients was 12~24 months,average of(18.92±4.17)months.The reverse Lachman test and the posterior drawer test were negative at the last postoperative follow-up.Knee range of motion(128.75±2.26)°,IKDC score(82.92±3.34),VAS(1.17±0.39)and Lysholm knee function score(85.00±3.02)significantly improved compared with those before surgery,and the differences were statistically significant(P<0.05).Conclusion The clinical effect of double posterioral-medial approach and double bone channel simple 8 suture in treatment of PCL tibial insertion avulsion fracture is accurate and worthy of promotion.