小切口微创治疗膝后叉韧带胫骨附着点撕脱性骨折

Clinical application of small incision minimally invasiver inter fixation treatment of avulsion fracture in the tibial attachment of posterior cruciate ligament

目的观察在膝后内侧弧行切口中应用空心螺钉微创治疗膝关节后叉韧带胫骨附着点撕脱性骨折的临床疗效。方法对28例后叉韧带胫骨附着点撕脱性骨折患者行膝关节后内侧弧行切口应用空心螺钉固定后,观察膝关节功能恢复情况。结果通过对本组患者随访6~24个月(平均13.6个月),切口均I期愈合,根据影像学评分,全部解剖复位,根据Lysholm膝关节评分系统进行评估,优26例,良1例,差1例,优良率92.86﹪。结论该手术入路具有创伤小、显露充分、组织损伤轻、并发症少等优点。空心螺钉固定具有操作简便、固定牢固、可早期行功能锻炼。两者结合可使膝关节功能恢复良好。

Objective To discuss the clinical effects of avulsion fracture in the tibial attachment of posterior cruciate ligament in treatment with minimally invasive cannulated screw fixation arc incision to posterior knee joint.Methods From July 2008 to October 2012,28 cases who had suffered from avulsion fracture in the tibial attachment of posterior cruciate ligament were treated with cannulated screw inner posterior arc incision of knee joint,and the functional recovery of the knee joint was evaluated after followed-up.Results With an average of 13.6-month follow-ups(range from 6 to 24 months) showed that all incisions primarily healed,and good apposition and bony union were achieved in all the cases by postperative radiographic examination.According to the criteria for knee function set up by Lysholm,the knee functions were excellent in 26 cases,good in 1 and poor in 1,with the good to excellent rate being 92.86%.Conclusion The operation through posterior knee approach has many advantage.It is less traumatic,can provide clear exposure,fewer complications and so on.Cannulated screw fixation are easy to use,firm fixation,earlier functional exercise,so combine them is beneficial to fracture healing and early functional recovery.