前交叉韧带胫骨棘止点撕脱骨折不同内固定疗效分析_临床医学论文.docVIP

前交叉韧带胫骨棘止点撕脱骨折不同内固定疗效分析_临床医学论文 前交叉韧带胫骨棘止点撕脱骨折不同内固定疗效分析_临床医学论文 作者：高彦平，吴宇峰,伍中庆，苏培基，姜雪梅，李义凯 【关键词】 前交 　　摘 要：［目的］明确前交叉韧带胫骨棘止点撕脱骨折不同内固定对膝关节稳定性和运动功能的影响。［方法］对45例前交叉韧带胫骨棘止点撕脱骨折患者分别进行关节镜下钢丝、丝线、螺钉复位内固定，术后定期随访，按Lysholm膝关节功能评分和IKDC膝关节功能评分对术后膝关节功能进行评估，判断患肢整体功能恢复情况。［结果］关节镜下复位内固定取得了较好的膝关节稳定性和运动功能，膝关节活动范围正常，关节功能良好；关节镜复位内固定术后6个月Lysholm膝关节功能评分为(922±24）分，术后1 a Lysholm膝关节功能评分(951±27）分；钢丝组、丝线组、螺钉组等内固定之间的Lysholm膝关节功能评分无显著性差异(Pgt;005)。［结论］关节镜下钢丝、丝线、螺钉复位内固定是前交叉韧带胫骨棘止点撕脱骨折的重要治疗手段，术后可获得良好的膝关节功能和稳定性。 　　关键词：前交叉韧带； 胫骨棘骨折； 撕脱骨折; 关节镜 　　Abstract：［Objective］To research the knee joint stability and movement function of the anterior cruciate ligament avulsion fracture from the tibial spine, which was fixated by differently inside fixation.［Method］Fortyfive patients with the anterior cruciate ligament avulsion fracture from the tibial spine were operated and fixated with steel wire, thread and screw under arthroscopy respectively, all cases were followed up regularly after operation, then the overall recovery condition of knee functions were judged according to the evaluate of Lysholm.［Result］There were better knee joint stability, movement function and activities scope after operation; the knee joint Lysholm evaluate was (92 2 ± 2 4) at 6 months after operation and the Lysholm evaluate was (951 ± 2 7 ) 1 year later, and the knee joint Lysholm evaluate showed no significant difference ( P gt; 005 ) among the group of steel wire , thread and screw.［Conclusion］It was a important method to fix the anterior cruciate ligament avulsion fracture from the tibial spine by the steel wire , thread and screw under arthroscopy, which can obtain good knee joint function and stability after the operation. Key words：Anterior cruciate ligament; Fracture of the tibial spine; Avulsion fracture; Arthroscopy 　　前交叉韧带(anteriorcruciate 1igament，ACL)胫骨止点撕脱骨折是常见的膝关节损伤之一，常由急速减速致膝关节猛烈过伸所致［1］。无明显移位的骨折可通过保守治疗得到很好的固定，但对于明显移位的骨折，多数外科医生认为还是需要坚强内固定的，以避免可能出现的膝关节不稳、髁间撞击症及膝伸直受限等并发症［2］。近年来，关节镜技术的应用为ACL胫骨止点撕脱骨折的治疗提供了新的选择，关节镜下进行骨折的复位内固定取得了较大