关节镜下双排缝线固定治疗前交叉韧带胫骨止点撕脱骨折

廖欣宇; 张瑶璋; 钟瑞颖; 杨登军; 张奇爱; 何璐; 张红; 郑亚星; 王福科

doi:10.12259/j.issn.2095-610X.S20220906

关节镜下双排缝线固定治疗前交叉韧带胫骨止点撕脱骨折

doi: 10.12259/j.issn.2095-610X.S20220906

1.
昆明医科大学第一附属医院运动医学科
2.
精神科，云南昆明　650032
3.
湖南师范大学附属第一医院/湖南省人民医院康复医学科，湖南长沙　410000

基金项目: 云南省陈世益专家工作站基金资助项目（2018IC102）；云南省骨关节疾病临床医学中心基金资助项目（zx2019-03-04）

详细信息

作者简介:
廖欣宇（1996～），男，湖南长沙人，医学硕士，主要从事骨关节损伤修复与重建工作

张瑶璋与廖欣宇对本文有同等贡献

通讯作者:
王福科，E-mail：wfk.04@126.com

中图分类号: R683.42
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- 被引次数: 0
出版历程
- 收稿日期: 2022-06-12
- 网络出版日期: 2022-09-07
- 刊出日期: 2022-09-29

Treatment of Avulsion Fracture of Anterior Cruciate Ligament Tibial Insertion with Double Row Suture under Arthroscopy

1.
Dept. of Sports Medicine
2.
Dept. of Psychiatry，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan，650032
3.
Dept. of Rehabilitation Medicine，The 1st Affiliated Hospital of Hunan Normal University/Hunan Provincial People’s Hospital， Changsha Hunan 410000，China

摘要

摘要: 目的探讨关节镜下双排缝线固定治疗前交叉韧带胫骨止点撕脱骨折的疗效。方法选择昆明医科大学第一附属医院运动医学科2017年1月至2020年12月收治的符合纳入、排除标准的前交叉韧带胫骨止点撕脱骨折患者35例，所有患者均在关节镜下行双排缝线固定治疗。比较患者术前与术后12月的Lysholm评分、国际膝关节文献委员会评分。所有入组患者均签署相关知情同意书，试验方案经昆明医科大学第一附属医院伦理委员会通过。结果患者12月复查时，Lysholm评分、IKDC评分均高于术前，且差异有统计学意义（Lysholm评分：（91.143±3.228）分vs（39.343±4.721）分，t = 60.526，P < 0.001；IKDC评分：（89.171±3.510）分vs（39.143±4.044）分，t = 69.368，P < 0.001）。结论关节镜下Versalok锚钉双排缝线固定法手术操作简单，即能保证撕脱骨块的稳定固定又能恢复前交叉韧带的张力，恢复膝关节稳定性。
- 前交叉韧带胫骨止点撕脱骨折 /
- Versalok锚钉 /
- 关节镜 /
- 微创治疗 /
- Meyers-Mckeever分型
Abstract: Objective To investigate the effect of double row suture fixation on avulsion fracture of anterior cruciate ligament （ACL） tibial insertion under arthroscopy. Methods A total of 35 patients with avulsion fracture of anterior cruciate ligament tibial insertion and meeting the inclusion and exclusion criteria were selected from the Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2020. All patients were treated with double row sutures under arthroscopy. Lysholm score and International Committee for Knee Literature score were compared between the patients before and 12 months after the surgery. All the enrolled patients signed the relevant informed consent, and the trial plan was approved by the Ethics Committee of the First Affiliated Hospital of Kunming Medical University. Results Lysholm score and IKDC score at 12 months of review were higher than those before the surgery, and the differences were statistically significant （Lysholm score: （91.14±3.22） vs （39.34±4.72）, t = 60.53, P < 0.001; IKDC score: （89.17±3.51） vs （39.14±4.04）, t = 69.37, P < 0.001. Conclusion The Versalok anchor double-row suture fixation method under arthroscopy is simple and can ensure the stable fixation of avulsed bone and restore the tension of ACL and stability of knee joint.
- Avulsion fracture of anterior cruciate ligament tibial insertion /
- Versalok anchors /
- Arthroscopy /
- Minimally invasive treatment /
- Meyers-Mckeever parting

HTML全文

图 1 关节镜下Versalok锚钉双排缝线固定手术方法

A：清理胫骨足印区；B：在胫骨足印区中前1/3内侧钻取骨道；C：在胫骨足印区中前1/3外侧钻取骨道；D：在骨块-前交叉韧带交界处中前1/3穿线；E：在骨块-前交叉韧带交界处中后1/3穿线；图F为各穿两道线后的前交叉韧带止点端；G：双排法布线后置入Versalok锚钉；H：转动轮盘收紧缝线；I：测试骨块复位是否牢固及前交叉韧带的紧张度。

Figure 1. Surgical method of Versalok anchor double row suture fixation under arthroscopy

下载: 全尺寸图片幻灯片

图 2 典型患者影像学资料及前交叉韧带重建术中关节镜下情况

A：术前MRI，箭头处可见前交叉韧带胫骨止点处骨撕脱；B：术前X线，箭头处可见骨折线；C：术中关节镜下，箭头处可见前交叉韧带胫骨止点端撕脱的骨块；D：关节镜下双排缝线固定后的前交叉韧带；E：术后6月MRI，箭头处可见前叉韧带位置良好；F：术后6月X线，可见骨折线消失。

Figure 2. Imaging data of typical patients and the arthroscopic situation during anterior cruciate ligament reconstruction

下载: 全尺寸图片幻灯片

表 1 患者的一般资料 [（$\bar x \pm s $）/n]

Table 1. General patient information [（$\bar x \pm s $）/n]

指标	数据
性别（男/女）	19/16
年龄（岁）	29.114 ± 6.429
膝关节位置（左/右）	14/21
Meyers-Mckeever分型（Ⅱ型/Ⅲ型）	15/20
受伤至手术时间（d）	5.943 ± 2.678

下载: 导出CSV

表 2 患者术后12个月时与术前Lysholm评分、IKDC评分比较[n = 35，（$\bar x \pm s $），分]

Table 2. Comparison of Lysholm score and IK9DC score between patients 12 months after surgery and those before surgery [n = 35，（$\bar x \pm s $），points]

时间	Lysholm评分	IKDC评分
术前	39.343 ± 4.721	39.143 ± 4.044
术后12月	91.143 ± 3.228	89.171 ± 3.510
t	60.526	69.368
P	< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

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