镜下Endo-Button固定后交叉韧带胫骨撕脱骨折

Arthroscopic Endo-button fixation of posterior cruciate ligament tibial avulsion fracture

摘要:

［目的］ 探讨镜下 Endo-Button 固定后交叉韧带胫骨撕脱骨折的临床效果。［方法］ 2016 年 2 月—2020 年 2 月共收治后交叉韧带胫骨撕脱骨折患者 17 例，行关节镜下辅助后内侧小切口，采用 Endo-Button 带袢钢板治疗。总结临床与影像结果。［结果］所有患者均顺利完成手术，术中无神经、血管损伤等严重并发症，手术时间平均（87.09±19.41）min，术中出血量平均（57.09±10.76）ml，术后切口均一期愈合，愈合时间平均（12.09 ±2.73）d。所有患者随访（29.73±7.29）个月，部分负重行走时间平均（42.12±5.98）d， 去掉膝关节保护支具时间平均（56.32±9.98）d，完全负重行走时间平均（12.07±1.23）周。末次随访时 IKDC 评分、Lysholm 评分、Tegner 评分及术后膝关节运动范围均较术前显著增加（P<0.05），KT-1000 膝关节位移较术前显著减少（P<0.05），所有抽屉试验均阴性。影像方面，术后骨折复位良好，骨折在 12 周左右愈合。［结论］关节镜下 En- do-Button 带袢钢板治疗后交叉韧带胫骨止点撕脱骨折，创伤小，膝关节稳定性恢复良好。

Abstract:

[Objective] To investigate the clinical outcomes of arthroscopic Endo-button fixation of posterior cruciate ligament tibial avulsion fracture. [Methods] From February 2016 to February 2020, a total of 17 patients underwent arthroscopic reduction and Endo-but- ton fixation of posterior cruciate ligament tibial avulsion fractures with a assisted posterior medial small incision. The clinical and imaging results were summarized. [Results] All patients had operations completed successfully, with no serious complications such as nerve and blood vessel injury, whereas with operation time of (87.09±19.41) min, intraoperative blood loss of (57.09±10.76) ml, and excellent incision healing in (12.09 ±2.73) days. All patients were followed up for 29.73±7.29 months, and resumed partial weight-bearing walking in (42.12± 5.98) days, protective brace removed in (56.32±9.98) days, and full weight-bearing walking in (12.07±1.23) weeks. The IKDC, Lysholm and Tegner scores, as well as knee range of motion at the latest follow-up significantly increased compared with those preoperatively (P＜ 0.05) , whereas the tibial displacement measured by KT-1000 significantly reduced compared with preoperatively (P＜0.05) , with negative posterior drawer tests in all of them. Radiographically, the fracture was reduced well postoperatively and healed about 12 weeks. [Conclusion] This arthroscopic Endo-button fixation of posterior cruciate ligament tibial avulsion fracture has minimizing trauma and get good sta- bility recovery of the knee.