[1]朱文科,俞臻,王雨辰△,等.关节镜下套索环缝合联合带袢钛板治疗前交叉韧带胫骨止点骨折的疗效分析[J].中国中医骨伤科杂志,2023,31(02):52-57.
　ZHU Wenke YU Zhen WANG Yuchen YU Weizhong HE Zhangning JIA Chuan.Efficacy Analysis of Arthroscopic Lasso-Loop Stitch Combined with Endobutton on the Treatment of Tibial Insertion Fractures of Anterior Cruciate Ligament[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(02):52-57.
点击复制

关节镜下套索环缝合联合带袢钛板治疗前交叉韧带胫骨止点骨折的疗效分析()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年02期
页码:
52-57
栏目:
临床报道
出版日期:
2023-02-15

文章信息/Info

Title:
Efficacy Analysis of Arthroscopic Lasso-Loop Stitch Combined with Endobutton on the Treatment of Tibial Insertion Fractures of Anterior Cruciate Ligament
文章编号:
1005-0205(2023)02-0052-06
作者:
朱文科1; 俞臻2; 王雨辰1△; 俞伟忠1; 何樟宁1; 贾川1
1常州市武进中医医院骨伤科(江苏 常州,213161) 2苏州大学附属第三医院
Author(s):
ZHU Wenke1 YU Zhen2 WANG Yuchen1△ YU Weizhong1 HE Zhangning1 JIA Chuan1
1Orthopedics Department,Changzhou Wujin Traditional Chinese Medicine Hospital,Changzhou 213003, Jiangsu China; 2The Third Affiliated Hospital of Suzhou University, Changzhou 213003, Jiangsu China.
关键词:
前交叉韧带;  胫骨止点骨折;  关节镜;  套索环缝合;  带袢钛板
Keywords:
anterior cruciate ligament;  tibial insertion fracture;  arthroscopy;  lasso-loop stitch;  endobutton
分类号:
R683.42
文献标志码:
B
摘要:
目的:探讨关节镜下套索环缝合联合带袢钛板治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效。方法:选取2017年5月至2020年5月26例前交叉韧带止点骨折患者,均符合纳入标准。其中男17例,女9例; 年龄为18～49岁; 均行关节镜下套索环缝合联合带袢钛板治疗。比较术后X线片愈合情况,术前1 d与术后2周膝关节周径的差值及术前和术后6个月的Lysholm评分及IKDC评分。结果:26例患者均得到随访,均未发生术后感染,手术时间为40～60 min,平均为(51.88±5.61)min; 出血量为5～10 mL,平均为(7.23±1.45)mL; 术后随访时间为7～12个月,平均为(9.34±2.08)个月; 术中及术后3个月和6个月前抽屉及Lachman试验均为阴性; 术后膝关节周径为(40.62±3.92)cm,较术前(42.63±3.38)cm改善明显,差异有统计学意义(P<0.05); 术后6个月的Lysholm评分为(88.19±4.81)分,较术前(24.69±4.31)分明显提高。术后6个月的IKDC评分为(79.50±1.88)分,较术前(44.15±2.51)分明显改善。结论:关节镜下套索环缝合联合带袢钛板治疗前交叉韧带胫骨止点骨折操作简单,复位精准,术后膝关节功能恢复快,值得临床推广应用。
Abstract:
Objective:To investigate the clinical efficacy of arthroscopic lasso ring suture combined with loop titanium plate on the treatment of anterior cruciate ligament(ACL)tibial insertion avulsion fracture. Methods:26 patients with ACL insertion fracture were selected from May 2017 to May 2020. All patients met the inclusion criteria, including 17 males and 9 females, aged 18 to 49 years old. All patients were treated with lasso-ring suture combined with loop titanium plate under arthroscopy. The postoperative X-ray healing, the difference of knee circumference between 1 d before operation and 2 weeks after operation, and Lysholm score and IKDC score before operation and 6 months after operation were compared. Results:All 26 patients were followed up effectively, and no postoperative infection occurred. The operation time was 40 to 60 min((51.88±5.61)min), and the blood loss was 5 to 10 mL((7.23±1.45)mL). The follow-up time was 7 to 12 months((9.34±2.08)months). Drawer and Lachman tests were negative during the operation and 3 and 6 months after the operation. The circumference of knee joint after operation was(40.62±3.92)cm, which was significantly improved compared with that before operation(42.63±3.38)cm(P<0.05), with statistical significance. The Lysholm score at 6 months after operation was 88.19±4.81, which was significantly higher than that before operation(24.69±4.31). The IKDC score at 6 months after operation was 79.50±1.88, which was significantly higher than that before operation(44.15±2.51). Conclusion:Arthroscopic lasso-loop stitch combined with endobutton on the treatment of anterior cruciate ligament tibial insertion fractures is simple. The reduction is accurate, and the postoperative knee function recovery is fast. It is worthy of clinical recommendation.

参考文献/References:

[1] 夏炎.关节镜下栓桩固定治疗胫骨髁间前棘撕脱骨折[J].中华关节外科杂志(电子版),2021,15(4):499-502.
[2] 曹万军,白笋蓬.比较可吸收带线锚钉与缝线套扎治疗胫骨髁间嵴骨折[J].中华关节外科杂志(电子版),2021,15(3):379-382.
[3] 李浩,李海,沙霖,等.关节镜下空心螺钉与不可吸收缝线固定治疗儿童胫骨髁间嵴骨折的疗效对比[J].临床小儿外科杂志,2021,20(5):453-457.
[4] 于洋,王振虎,龚龙,等.关节镜下带螺纹克氏针张力带钢丝固定治疗胫骨髁间嵴骨折[J].中国矫形外科杂志,2016,24(22):2066-2068.
[5] 唐恒涛,肖鹏,朱旭,等.关节镜下“8”字缝线法治疗前交叉韧带胫骨髁间棘撕脱骨折[J].郑州大学学报(医学版),2014,49(5):761-764.
[6] 曾学珠,范程,汤波.关节镜下缝线联合Endobutton内固定术治疗青少年胫骨髁间嵴骨折的疗效[J].国际骨科学杂志,2020,41(4):248-251.
[7] 田进翔,杨东强,崔红林,等.关节镜下三点双“8”字联合外排锚钉固定与空心螺钉固定治疗成人胫骨髁间嵴骨折的疗效比较[J].中华骨与关节外科杂志,2022,15(7):532-537.
[8] SHIN C H,LEE D J,CHOI I H,et al.Clinical and radiological outcomes of arthroscopically assisted cannulated screw fixation for tibial eminence fracture in children and adolescents[J].BMC Musculoskelet Disord,2018,19(1):41.
[9] TUDISCO C,GIOVARRUSCIO R,FEBO A,et al.Intercondylar eminence avulsion fracture in children:long-term follow-up of 14 cases at the end of skeletal growth[J].J Pediatr Orthop B,2010,19(5):403-408.
[10] MEYERS M H,MCKEEVER F M.Fracture of the intercondylar eminence of the tibia[J].J Bone Joint Surg Am,1959,41(2):209-222.
[11] 肖坤,闵军,杨杰,等.改良缝线固定前交叉韧带胫骨止点撕脱骨折的疗效观察[J].实用骨科杂志,2020,26(10):938-941.
[12] 袁伟,齐玮,李春宝,等.RigidFix固定重建前交叉韧带的疗效研究[J].中华骨与关节外科杂志,2021,14(8):693-697.
[13] 李广峰,王思成,彭勇,等.关节镜下Fiber Tape环形内固定治疗前交叉韧带胫骨止点撕脱性骨折[J].中国组织工程研究,2020,24(10):1591-1596.
[14] 蒋艳芳,王健,王永健,等.前交叉韧带翻修重建术后中长期临床疗效及影响因素[J].北京大学学报(医学版),2021,53(5):857-864.
[15] 吴萌,高莉,夏亚一,等.Ⅰ期关节镜辅助下修复重建膝关节后外侧脱位合并多发韧带损伤的疗效观察[J].中国骨伤,2014,27(8):686-690.
[16] SHIMBERG J L,LESKA T M,CRUZ AI J R,et al.Is nonoperative treatment appropriate for all patients with type 1 tibial spine fractures? A multicenter study of the tibial spine research interest group[J].Orthop J Sports Med,2022,10(6):23259671221099572.
[17] 沈福祥,杜伟斌,陈荣良,等.关节镜下高强线联合外排锚钉治疗前交叉韧带胫骨止点撕脱骨折[J].中国骨伤,2019,32(11):1034-1037.
[18] 刘俊才,岳永川,李忠.关节镜下双头加压空心螺钉固定治疗青少年前交叉韧带胫骨止点撕脱骨折[J].中国修复重建外科杂志,2018,32(9):1172-1176.
[19] 陈巍,李彬,郑磊,等.关节镜下空心螺钉治疗前交叉韧带胫骨止点撕脱性骨折18例[J].中国中医骨伤科杂志,2016,24(7):58-59.
[20] 汪阳,陈丰,张卫国.关节镜下全内VERSALOK锚钉固定前交叉韧带止点撕脱性骨折19例[J].中国中医骨伤科杂志,2017,25(8):64-65.
[21] WATSON J N,MCQUEEN P,KIM W,et al.Bioabsorbable interference screw failure in anterior cruciate ligament reconstruction:a case series and review of the literature[J].Knee,2015,22(3):256-261.
[22] 刘忠国,陈青植,邱必成,等.线缆与丝线捆扎固定前交叉韧带胫骨止点撕脱性骨折[J].中国组织工程研究,2012,16(51):9684-9690.
[23] 华贤章,吴美平,谭明伟.关节镜下“8“字缝合前交叉韧带止点撕脱骨折30例[J].中国中医骨伤科杂志,2018,26(4):62-63.
[24] 刘镇煌,黄长明,傅仰攀,等.两种前交叉韧带胫骨止点撕脱骨折固定的生物力学比较[J].中国矫形外科杂志,2020,28(6):542-547.
[25] SEKIYA H,TAKATOKU K,KIMURA A,et al.Arthroscopic fixation with EndoButton for tibial eminence fractures visualised through a proximal superomedial portal:A surgical technique[J].J Orthop Surg(Hong Kong),2016,24(3):417-420.
[26] HIRANAKA T,FURUMATSU T,TANAKA T,et al.Combining pullout suture and retrograde screw fixation for anterior cruciate ligament tibial eminence avulsion fractures:a case report[J].J Orthop Surg(Hong Kong),2020,28(2):2309499020918681.
[27] 陈杰,吴美平.关节镜下带襻钢板治疗前交叉韧带止点撕脱骨折30例[J].中国中医骨伤科杂志,2020,28(6):66-68.

备注/Memo

备注/Memo:
基金项目:常州市武进区科技计划(社会发展)项目(WS202101)
△通信作者 E-mail:wyc0928@163.com
更新日期/Last Update: 2023-02-10