关节镜辅助膝关节后内小切口入路空心钉固定治疗后交叉韧带胫骨止点撕脱骨折.docVIP

关节镜辅助膝关节后内小切口入路空心钉固定治疗后交叉韧带胫骨止点撕脱骨折【摘要】 目的 探讨关节镜辅助下经膝关节后内侧小切口入路空心钉内固定治疗后交叉韧带胫骨止点撕脱骨折的临床效果。方法 对17例后交叉韧带胫骨止点撕脱骨折,在关节镜常规前侧入路进镜探查关节腔,处理发现的合并伤,并在镜下引导行后内侧小切口切开,骨折复位,并以4.0 mm空心钉加垫片内固定。术后定期随访6个月,了解骨折对位及愈合、膝关节稳定性及活动度,Lysholm 膝关节功能评分标准评估患肢功能恢复情况。结果 17例患者术后平均随访13.2 个月(6~23个月),骨折均一期愈合,无明显移位。后抽屉试验呈阴性14例,(+)者3例,无(++)以上者。关节活动度正常者12例,均无伸膝受限,2例有轻度屈膝受限。Lysholm 膝关节功能评分为94.3(85~100)分。结论 关节镜辅助下经膝关节后内侧小切口入路空心钉内固定治疗后交叉韧带胫骨止点撕脱骨折操作简便、安全、内固定效果可靠。 【关键词】 关节镜;后交叉韧带;撕脱骨折 A simplified approach with arthroscopic fixation for treatment of avulsion fracture of tibial insertion of the posterior cruciate ligament GUO Da-wei,ZHAO Zheng-jun,WANG Guang-xin.Department of orthopedics,the fourth people’s hospital of Shenyang,Liaoning 110031,China 【Abstract】 Objective To introduce the arthroscopic fixation via knee joint to the tibial insertion of the posterior cruciate ligament and the the clinical outcome.Methods 17 cases of acute avulsion fracture of the tibial insertion of posterior cruciate ligament underwent open reduction and internal fixation with arthroscopic assistance.under arthroscopy,the articular cavity was detected and the combined injury was treated.Using the posteromedial approach of knee joint,the fracture was reduced and fixed with 4.0 mm cannulated screws.Results The average follow-up time was 13.2 months(6-23 months).The fracture healed completely in all patients.The posterior drawer test resulted in negative in 14 patients,(+)in 3 patients postoperatively and the Lyshrolm score was 94.3(85-100).The motive ranges of the knee were normal in 12 patients.Flexion deficit was found in 2 cases.Conclusion The approach described is technically fairly easy,Safe and yields effective fixation for the avulsion fracture of tibial insertion of the posterior cruciate ligament 【Key words】 Arthroscopy; Osterior cruciate ligament; Vulsion fracture 后交叉韧带(posterior cruciate ligament,PCL)是维持膝关节稳定的重要结构。后交叉韧带胫骨止点撕脱骨折是一种特殊类型的后交叉韧带损伤,对于有移位且(++)以上松弛的损伤,保守治疗效果并不理想。本文介绍采用关节镜辅助经膝关节后内小切口应用空心钉固定对