Lu Hua-ding, Zeng Chun, Dong Yun-xu, Cai Dao-zhang, Wen Xiao-yue
Department of Orthopaedics, the 3rd Affiliated Hospital of Sun Yat-san University, Guangzhou 510630, Guangdong, China.
Zhongguo Gu Shang. 2011 Mar;24(3):195-8.
To study the curative effects of the treatment of tibial avulsion fracture of the posterior cruciate ligament with open reduction and steel-wire internal fixation.
From January 2003 to June 2009, 28 patients of tibial avulsion fracture of the posterior cruciate ligament were treated with open reduction and steel-wire internal fixation through posteromedial inverted "L" approach. There were 19 males and 9 females with an average age of 35.3 years old ranging from 16 to 55 years. The X-ray examination showed that there were II degree displaced in 10 cases and III degree in 18 patients. The affected lower extremity was put in a controlled hinge knee brace after operation. The patients were asked to do passive extension and flexion of the knee joint with the assistance of a CPM 2 weeks after operation,and allowed to be partial weight-bearing as tolerated with the hinged brace locked in extension if concomitant injuries allowed 4 weeks postoperatively. The brace were removed 6 weeks later.
Among them, 25 patients were followed up for 6 to 24 months with an average of 15 months. The X-ray examination showed satisfactory reduction, and bony union was obtained in all the patients. The Lachman test was negative in all patients. No complications such as malunion or joint stiffness were found. The extension of affected knee was normal and its flexion were (136 +/- 12) degrees. According to Lysholm knee score system,it was preoperatively (41.80 +/- 6.16) and (94.10 +/- 8.26) six months after surgery respectively. Twenty-two cases were excellent, 2 cases good and 1 fair.
Treatment of tibial avulsion fracture of the posterior cruciate ligament with open reduction and internal fixation with wires through posteromedial inverted "L" approach is a safe, effective method, due to its stable fixation and relatively low expense. It is believed as an ideal choice for tibial avulsion fracture of the posterior cruciate ligament.
探讨切开复位钢丝内固定治疗后交叉韧带胫骨止点撕脱骨折的疗效。
2003年1月至2009年6月，对28例后交叉韧带胫骨止点撕脱骨折患者采用后内侧倒“L”形切口切开复位钢丝内固定治疗。其中男19例，女9例；年龄16～55岁，平均35.3岁。X线检查显示，Ⅱ度移位10例，Ⅲ度移位18例。术后患侧下肢使用可控活动铰链膝关节支具。术后2周在CPM辅助下进行膝关节被动屈伸活动，若合并其他损伤允许，术后4周在伸直位锁定铰链支具的情况下部分负重。6周后去除支具。
其中25例获6～24个月随访，平均15个月。X线检查显示复位满意，所有患者均获得骨性愈合。所有患者Lachman试验阴性。未发现骨折畸形愈合、关节僵硬等并发症。患侧膝关节伸直正常，屈曲(136±12)°。根据Lysholm膝关节评分系统，术前平均(41.80±6.16)分，术后6个月平均(94.10±8.26)分。优22例，良2例，可1例。
采用后内侧倒“L”形切口切开复位钢丝内固定治疗后交叉韧带胫骨止点撕脱骨折，固定可靠，费用较低，是一种安全、有效的方法，是治疗后交叉韧带胫骨止点撕脱骨折的理想选择。
