镜下缝线联合Tightrope固定后交叉韧带胫骨撕脱骨折△

Arthroscopic suture combined with Tightrope fixation for posterior cruciate ligament tibial avulsion fracture

摘要:

[目的] 探讨镜下缝线联合 Tightrope 固定治疗后交叉韧带 （posterior cruciate ligament, PCL） 胫骨止点撕脱性骨折的临床疗效。[方法] 回顾性分析 2020 年 1 月—2023 年 6 月采用镜下缝线联合 Tightrope 固定 PCL 胫骨止点撕脱性骨折 26 例患者，评估临床与影像资料。[结果]26 例患者均顺利结束手术，手术时间（68.3±10.2）min，出血量（26.0±7.4）mL，切口长度 （5.1±0.5）cm，住院时间（4.2±0.4）d。患者均获得 1 年以上的随访，平均（14.8±1.9）个月，与术前相比，末次随访时 IKDC 评分、Lysholm 功能评分、膝关节活动度和 VAS 评分均显著改善 （P＜0.05）。影像方面，后抽屉应力位胫骨后移显著减少 [(8.7± 1.1) mm, (1.3±0.3) mm, P＜0.001]。[结论]镜下缝线联合 Tightrope 固定治疗 PCL 止点撕脱性骨折创伤小，术后膝关节功能恢复较佳，近期疗效确切。

Abstract:

[Objective] To evaluate the clinical efficacy of arthroscopic suture combined with Tightrope fixation for posterior cruciate ligament (PCL) tibial avulsion fracture. [Methods] A retrospective study was conducted on 26 patients who had PCL tibial avulsion fracture fixed with arthroscopic suture combined with Tightrope from January 2020 to June 2023. The clinical and imaging data were evaluated. [Results] All the 26 patients were operated on successfully with operation time of (68.3±10.2) min, the blood loss of (26.0±7.4) mL, the incision length of (5.1±0.5) cm, and the hospital stay of (4.2±0.4) days. All of them were followed up for more than 12 months, with an average of (14.8±1.9) months. Compared with those preoperatively, the IKDC, Lysholm, VAS scores and knee range of motion significantly improved at the last follow-up (P＜0.05). As for imaging, the tibial posterior displacement under posterior drawer stress was significantly reduced [(8.7± 1.1) mm, (1.3±0.3) mm, P＜0.001]. [Conclusion] Arthroscopic suture combined with Tightrope fixation for PCL tibial avulsion fracture has advantages of minimal invasive surgery and better functional recovery, and achieves satisfactory short-term clinical consequence.