全镜下缝线联合Endobutton固定治疗PCL胫骨止点撕脱性骨折
摘要
目的:探讨全关节镜下以缝线联合带袢钛板Endobutton内固定术治疗后交叉韧带(PCL)胫骨止点撕脱性骨折的临床疗效。方法:选取2014年10月至2018年3月东莞市第八人民医院12例PCL胫骨止点撕脱骨折患者在全关节镜下手术,采用膝关节后内、后外入路复位骨折块,以PCL胫骨定位器从胫骨结节前内侧向撕脱骨块两侧的胫骨平台后方钻入导针,4.5 mm空心钻钻骨孔,2～3条爱惜邦5号线穿过PCL腱骨结合部引到胫骨结节前内侧穿过Endobutton打结固定。结果:12例患者术后均随访8～28月。所有患者骨折均能骨性愈合。仅1例发生后抽屉试验Ⅰ°松弛,但膝关节无明显不稳。所有患者膝关节屈伸活动均无受限。膝关节Lysholm评分术前为(40.0±25.1)分,术后6月为(96.0±3.2)分。结论:PCL胫骨止点撕脱性骨折关节镜下复位缝线+Endobutton内固定术有微创、出血少、操作方便、疗效佳等优点。
引文
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[3]Chen W,Tang D,Kang L.Effects of microendoscopy-assisted reduction and Screw?xation through a single mini-incision on posterior cruclate ligament tibial avulsion fracture[J].Arch Orthop Trauma Surg,2012,132(4):429-435.
[4]Martinez-Moreno JL,Blanco-Blanco E.Avulsion fractures of the posterior cruciate ligament of the knee:an experimental percutaneous rigid?xation technique under arthroscopic control[J].Clin Orthop RelatRes,1988,237(237):204.
[5]Zhao J,He Y,Wang J.Arthroscopic treatment of acute tibial avulsion fracture of the posterior cruciate ligament with suture?xation technique through Y-shaped bone tunnels[J].Arthroscopy,2006,22(2):172.
[6]卢弘栩,皇甫小桥,张君,等.关节镜下空心钉固定治疗后交叉韧带胫骨止点撕脱骨折[J].实用骨科杂志,2012,18(9):797-799.