镜下改良双“8”字缝线固定II型胫骨棘撕脱骨折

Modified 8-figure double suture loop for fixation of type II tibial interspinal avulsion fracture under arthroscope

摘要:

[目的] 探讨关节镜下改良双“8”字双隧道治疗Meyers-MckeeverⅡ型胫骨髁间嵴骨折的临床疗效。[方法] 回顾性分析2015 年10 月—2020 年5 月应用关节镜下改良双“8”字双隧道线袢固定Meyers-MckeeverⅡ型胫骨髁间嵴骨折的17 例患者的临床资料，评价临床及影像结果。[结果] 所有患者均顺利完成手术，无严重并发症。随访时间平均（18.5±6.9） 个月，随着术前、术后3 个月和末次随访的时间推移，VAS 评分显著降低[(6.8±0.8), (2.3±0.5), (0.9±07), P＜0.001]，Lyshol 评分[(51.9±4.2), (81.3±1.4), (91.2±2.0), P＜0.001]、IKDC 评分[(53.4±2.9), (79.7±2.8), (89.5±2.4), P＜0.001]、ROM [(67.6±1.1)°, (102.2±3.8)°,(124.1±1.0)°, P＜0.001] 均显著增加，前抽屉试验和Lachman 试验均显著改善（P＜0.05）。影像方面，骨折复位全部为优，平均骨折愈合时间（11.2±0.8） 周。[结论] 关节镜下改良双“8”字双隧道治疗Meyers-MckeeverⅡ型胫骨髁间嵴骨折可以达到解剖复位和牢固固定，手术疗效满意。

关键词:关节镜;骨折固定术;胫骨髁间嵴骨折;临床疗效

Abstract:

[Objective] To investigate the clinical outcomes of modified 8-figure double suture loop for fixation of type II tibial interspi-nal avulsion fracture under arthroscope. [Methods] A retrospective study was conducted on 17 patients who underwent abovesaid proce-dures for Meyers-Mckeever type II tibial interspinal fracture under arthroscope from October 2015 to May 2020. The clinical and imagingdocuments were evaluated. [Results] All patients were successfully operated without serious complications, and followed up for (18.5±6.9)months in a mean. With time preoperatively, 3 months postoperatively and the last follow-up, the VAS score decreased significantly [(6.8±0.8), (2.3±0.5), (0.9±07), P＜0.001], while the Lysholm score [(51.9±4.2), (81.3±1.4), (91.2±2.0), P＜0.001], IKDC scores [(53.4±2.9), (79.7±2.8), (89.5±2.4), P＜0.001], and ROM [(67.6±1.1)°, (102.2±3.8)°, (124.1±1.0)°, P＜0.001] increased significantly. In addition, the knee laxi-ty in terms of anterior drawer test and Lachman test were also significantly improved (P＜0.05). Regarding imaging, all patients got fracturereduction excellent, with the mean fracture healing time of (11.2±0.8) weeks. [Conclusion] The modified 8-figure double suture loop fixa-tion under arthroscope does achieve anatomical reduction and firm fixation of Meyes-McKeever type II tibial interspinal fractures with satis-factory clinical consequences.

Key words:arthroscopy; fracture fixation; tibial interspinal fractures; clinical outcomes