| 陈昊,孙宝亭,张有磊,等.关节镜下四方位微骨道双Orthocord线固定治疗前交叉韧带胫骨止点撕脱骨折.骨科,2022,13(3): 212-217. |
| 关节镜下四方位微骨道双Orthocord线固定治疗前交叉韧带胫骨止点撕脱骨折 |
| Treatment of Avulsion Fracture of the Tibial Anterior Cruciate Ligament with Dual Orthocord Suture Fixation in Four Directions under Arthroscopy |
| 投稿时间：2021-10-14 |
| DOI：10.3969/j.issn.1674-8573.2022.03.004 |
| 中文关键词: 撕脱骨折 前交叉韧带 关节镜 |
| 英文关键词: Avulsion fracture Anterior cruciate ligament Arthroscopy |
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| 中文摘要: |
| 目的 评价关节镜下利用Orthocord缝线经胫骨四方位2 mm微型骨道缝合治疗膝关节前交叉韧带（anterior cruciate ligament，ACL）胫骨止点撕脱骨折的临床疗效。方法 本研究是一项前瞻性研究，选择我院2019年7月至2021年7月收治的23例ACL胫骨止点撕脱骨折病人作为观察对象，采用关节镜下Orthocord缝线经胫骨微型骨道内固定术治疗。末次随访时对所有病人进行膝关节Lachman试验、抽屉试验、轴移试验检查，通过Lysholm膝关节评分量表及国际膝关节评分委员会（International Knee Documentation Committee，IKDC）2000膝关节功能主观评估表量化评估术后膝关节功能。结果 23例病人术后切口均一期愈合，术后3个月骨折达到临床愈合标准。末次随访时2例轴移试验（+），1例Lachman试验（+），1例前抽屉试验（+），其余病人检查结果均为阴性；末次随访时病人关节活动度由术前的49.37°±7.69°提高到末次随访时的126.38°±5.58°，Lysholm评分由术前的（29.39±6.35）分提高至（72.78±13.16）分，IKDC主观评分由术前的（29.13±7.45）分提高至（55.04±10.29）分，术前与末次随访时比较，差异均有统计学意义（P＜0.05）。结论 关节镜下经2 mm骨道Orthocord线缝合固定ACL止点的方法，不仅固定牢固，而且不需二次手术取出内固定物，是有效的治疗方法。 |
| 英文摘要: |
| Objective To evaluate the clinical efficacy of dual Orthocord suture fixation with 2-mm micro-tunnel in four directions under arthroscopy for avulsion fracture of the tibial anterior cruciate ligament (ACL). Methods A prospective study was performed on 23 patients with avulsion fracture of ACL tibial insertion treated in our hospital from July 2019 to July 2021. The patients were treated with dual Orthocord suture fixation with micro-tunnel under arthroscopy. At the last follow-up, all patients were examined by Lachman test, drawer test and axial shift test. The postoperative knee function was quantitatively evaluated by Lysholm knee score scale and International Knee Documentation Committee (IKDC) 2000 knee function subjective evaluation scale. Results All the incisions obtained the primary healing, and the fractures reached the clinical healing standard 3 months after the operation. At the last follow-up, axial shift test was positive in 2 cases, Lachman test positive in 1 case, anterior drawer test positive in 1 case, and the remaining patients were negative. At the last follow-up, the range of motion of the patient's joint increased from 49.37°±7.69° before operation to 126.38°±5.58°, the Lysholm score increased from 29.39±6.35 to 72.78±13.16, and the IKDC subjective score increased from 29.13±7.45 to 55.04±10.29. There were significant differences between before operation and at the last follow-up (P＜0.05). Conclusion The arthroscopic fixation of the ACL with the Orthocord suture of the tibia micro-tunnel can not only restore the knee function quickly after the operation, but also does not need the second operation to remove the internal fixation, which is a safe and effective treatment method. |
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