微创小切口下双排线桥技术治疗后交叉韧带胫骨止点粉碎性骨折12例
摘要
目的:观察微创小切口联合双排线桥技术治疗后交叉韧带胫骨止点粉碎性骨折的疗效。方法:回顾性分析2015年1月至2018年5月后交叉韧带胫骨止点粉碎性骨折的患者资料。男10例,女2例,平均年龄40岁(25～55岁);按Meyers-McKeever分型为Ⅳ型。所有的患者采用微创的膝后内侧入路,用双排线桥技术固定,术后早期指导功能康复锻炼。采用Lysholm和国际膝关节评分委员会(IKDC)评分评价疗效。结果:所有患者均获得随访,时间8～29个月。术后X线片显示骨折复位满意,无神经、血管损伤等并发症,骨折均骨性愈合。根据Lysholm评分标准,患侧膝关节评分平均为(92.88±7.30)分,优9例,良好3例,与健侧比较差异无统计学意义(P>0.05)。根据IKDC评分标准,患侧膝关节评分平均为(90.34±5.51)分,A级9例,B级3例,与健侧比较差异无统计学意义(P>0.05)。结论:运用微创小切口下双排线桥技术治疗后交叉韧带胫骨止点粉碎性骨折具有手术入路简单、安全,骨折固定坚固可靠等优点,可获得满意疗效。
引文
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[17]卢华定,曾春,董云旭,等.钢丝内固定治疗后交叉韧带胫骨止点撕脱骨折[J].中国骨伤,2011,24(3):195-198.
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[19]SASAKI,ALBUQUERQUE R F,AMATUZZI M M,et al.Open screw fixation versus arthroseopic suture fixation of tibial posterior cruciate ligament avulsion injuries:a mechanical omparison[J].Arthroscopy,2007,23(11):1226-1230.
[20]董辉详,黄长明.关节镜下双排锚钉固定治疗前交叉韧带胫骨止点撕脱骨折[J].中国矫形外科杂志,2016,24(22):2062-2065.
[2] AMADI H O,GUPTE C M,LIE D T,et al.A biomechanicalstudy of the menisci of emoral ligaments and their contribution to contact pressure reduction in the knee[J].Knee Surg Sports Traumatol Arthrosc,2008,16(11):1004-1008.
[3] WOO S L,ABRAMOWITCH S D,KILGER R,et al.Biomechanics of knee ligaments:injury,healing,and repair[J].J Biomech,2006,39(1):1-20.
[4]王秀峰.锚钉与缝线桥技术治疗后交叉韧带胫骨止点撕脱骨折[J].中国中西医结合外科杂志,2014,20(4):422-423.
[5] ZHAO J,HE Y,WANG J.Arthroscopic treatment of acute tibial avulsion fracture of the posterior cruciate ligament with suture fixation technique through Y-shaped bone tunnels[J].Arthroscopy,2006,22(2):172-181.
[6]赵金忠,蒋垚.关节镜下缝线固定治疗后交叉韧带胫骨止点撕脱骨折[J].中华创伤杂志,2003,19(9):569-570.
[7]黄迅悟,孙继桐,关长勇,等.关节镜下治疗后交叉韧带胫骨附着部撕脱骨折[J].中华创伤骨科杂志,2006,8(1):91-92.
[8] KIM S J,SHIN S J,CHO S K,et al.Arthroscopic suture fixation for bony avulsion of the posterior cruciate ligament[J].Arthroscopy,2001,17(7):776-780.
[9]邢宝瑞,韩广普,臧建成,等.3种手术入路治疗后交叉韧带胫骨止点撕脱骨折的疗效比较[J].中医正骨,2011,23(9):9-11.
[10]COVEY C D,SAPEQA A A.Injuries of the posterior cruciate ligament[J].J Bone Joint Surg Am,1993,75(9):1376-1386.
[11]曾博龙,余斌,田京,等.膝后“L”型切口治疗单纯后交叉韧带损伤[J].中国矫形外科杂志,1999,6(5):365-367.
[12]蒋昊靖,何向东,金勤富.缝线锚钉内固定治疗后交叉韧带胫骨止点撕脱骨折[J].中国骨与关节损伤杂志,2013,28(12):1184-1185.
[13]王益民,韦兆祥,庄民,等.膝后内侧微创小切口带线锚钉固定治疗后交叉韧带胫骨止点粉碎性骨折[J].中国骨与关节损伤杂志,2010,25(12):1115-1116.
[14]ZHANG X C,CAI G P,XU J,et al.A minimally invasive postero-medial approach with suture anchors for isolated tibial avulsion fracture of the posterior cruciate ligament[J].Knee,2013,20(2):96-99.
[15]欧阳植松,李棋,李箭.经膝后正中小切口可吸收螺钉固定治疗后交叉韧带胫骨止点撕脱骨折[J].中国骨伤,2013,26(9):720-723.
[16]缪国平,张弛,王俊,等.小切口入路空心螺钉和缝线锚钉治疗后交叉韧带胫骨止点撕脱骨折的比较[J].中华骨与关节外科杂志,2012,5(3):255-257.
[17]卢华定,曾春,董云旭,等.钢丝内固定治疗后交叉韧带胫骨止点撕脱骨折[J].中国骨伤,2011,24(3):195-198.
[18]SMITH C,ALEXANDER S,HILL A,et al.A biomechanical comparison of single and double-row fixation in arthroscopic rotator cuff repair[J].J Bone Joint Surg Br,2006,88(11):2425-2431.
[19]SASAKI,ALBUQUERQUE R F,AMATUZZI M M,et al.Open screw fixation versus arthroseopic suture fixation of tibial posterior cruciate ligament avulsion injuries:a mechanical omparison[J].Arthroscopy,2007,23(11):1226-1230.
[20]董辉详,黄长明.关节镜下双排锚钉固定治疗前交叉韧带胫骨止点撕脱骨折[J].中国矫形外科杂志,2016,24(22):2062-2065.