[1]陈亮△ 高大伟 吴宇峰 陈景杨.单锚钉张力带技术治疗后交叉韧带胫骨附着点骨折锚定点安全距离的初步研究[J].中国中医骨伤科杂志,2021,29(06):13-16.
　CHEN Liang GAO Dawei WU Yufeng CHEN Jingyang.A Study of Anchor Point Safety Distance in the Treatmentof PCL Tibial Attachment Point Fracture bySingle-Anchor Tension Band Surgical Treatment[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(06):13-16.
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单锚钉张力带技术治疗后交叉韧带胫骨附着点骨折锚定点安全距离的初步研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年06期
页码:
13-16
栏目:
临床研究
出版日期:
2021-06-15

文章信息/Info

Title:
A Study of Anchor Point Safety Distance in the Treatmentof PCL Tibial Attachment Point Fracture bySingle-Anchor Tension Band Surgical Treatment
文章编号:
1005-0205(2021)06-0013-04
作者:
陈亮1△ 高大伟1 吴宇峰1 陈景杨1
1广东省中山市中医院(广东 中山,528400)
Author(s):
CHEN Liang1△ GAO Dawei1 WU Yufeng1 CHEN Jingyang1
1Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,Guangdong China.
关键词:
后交叉韧带附着点;  单锚钉张力带;  安全距离
Keywords:
posterior cruciate ligament attachment point;  band of single anchor tension;  safe distance
分类号:
R683.42
文献标志码:
A
摘要:
目的:探讨利用单枚外排锚钉张力带技术,微创手术治疗后交叉韧带(Posterior Cruciate Ligament,PCL)胫骨附着点撕脱性骨折,外排钉锚定点的安全距离及其临床效果。方法:收集2018年2月至2020年1月就诊的所有后交叉韧带胫骨附着点撕脱性骨折病例,并采用单枚外排锚钉张力带技术微创手术治疗,术中利用肩袖缝合推结器牵引锚定缝线,确认与骨床边缘最佳距离,在骨块解剖复位并且稳固后,确定锚定点。术后随访观察骨折愈合、膝关节功能恢复及并发症发生情况,汇总分析锚定点的安全距离对术后临床效果的影响。结果:20例后交叉韧带胫骨附着点撕脱性骨折的患者采用单枚外排锚定张力带技术行微创手术治疗,其中男12例,女8例; 年龄19～61岁; 右膝15例,左膝5例。所有患者均获得随访,随访时间12～18个月,术口Ⅰ期愈合。骨折均Ⅰ期愈合,愈合时间8～12周。外排钉锚定点最佳安全距离为距离骨床边缘0.6～1.0 cm; 术后6个月患侧Lysholm膝关节评分为(94.5±1.4)分,健侧为(96.7±1.7)分; 双侧Lysholm膝关节评分的差异无统计学意义(t=0.668,P=0.13)。无内固定失效、创伤性关节炎等并发症发生。结论:单锚钉张力带技术治疗Meyers-McKeeverⅡ、Ⅲ型PCL 胫骨止点撕脱骨折,充分利用了锚钉缝线及后交叉韧带的张力,通过平行四边形法则,诸力的合力又形成对骨折端的下压力,确保骨折端的稳定并有利于骨质的修复,该方法具有骨折复位好,术后关节功能恢复早,手术时间短、创伤小,无需二次手术拆除内固定等优点。
Abstract:
To explore the clinical efficacy and the anchor point safety distance in the treatment of posterior cruciate ligament(PCL)tibial attachment point fracture by minimally invasive single-anchor tension band technique.Methods:All patients with avulsion fracture of tibial attachment point of PCL from February 2018 to January 2020 were collected and treated with a single-anchored tension band technique and minimally invasive surgery. During the operation, the rotator cuff suturing pusher was used to pull the anchoring suture to confirm the best distance from the edge of the bone bed. When the bone was anatomically reset and stabilized, the anchor point was determined. Postoperative follow-up observation of fracture healing, knee function recovery and complications occurred were recorded. The impact of the safety distance of the anchor point on the postoperative clinical efficacy was discussed by summary analysis.Results:20 patients(12 males and 8 females)of avulsion fracture of tibial attachment point of PLC were treated with a single efflux anchored tension band technique and minimally invasive surgery, There were 15 cases of right knee, 5 cases of left knee. The age ranged from 19 to 61 years old. All patients were followed up. All wounds achieved first union. Each patient’s follow-up time was 12 to 18 months. All fractures healed by first intention and the healing time was 8 to 12 weeks. The best safe distance for the anchor point of the outer row of nails was within 0.6 to 1.0 cm from the edge of the fracture line. Six months after the operation, the Lysholm score of the affected knee joint was(94.5±1.4)points and the score of unaffected side was(96.7±1.7)points. But they did not achieve statistical significance(t=0.668, P=0.13). The fractures healed in all cases with good function of joint, and without screw loosening or traumatic arthritis. Conclusion:Minimally invasive single-anchor tension band technique treats PCL tibial avulsion fractures(the type of Meyers-McKeever Ⅱ and Ⅲ)by using the tension of the anchor suture and the posterior cruciate ligament. The resultant force which is conducive to stability during the bone repair will create pressure under the fracture end by the parallelogram rule. This method has the advantages of stabler internal fixation, the more satisfactory recovery of articular function, fewer operative trauma, shorter operation time. The technique does not need to have a second operation to remove the internal fixation.

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备注/Memo

备注/Memo:
基金项目:2020年度中山市第一批社会公益与基础研究项目(2020B1058)中山市新型研发机构产业化项目(2016F2FC0019)科技部2018重点研发项目(2018YFB1105600)
△通信作者 E-mail:chenliang211@163.com
更新日期/Last Update: 2021-06-15