Department of Orthopaedics, Southeast Hospital of Xiamen University, Zhangzhou, Fujian, China.
Arch Orthop Trauma Surg. 2012 Apr;132(4):429-35. doi: 10.1007/s00402-011-1426-y. Epub 2011 Nov 13.
There are various surgical approaches for the treatment of posterior cruciate ligament (PCL) injury-associated tibial fracture avulsion, including arthroscopy-assisted surgery and open posterior surgery. However, none of these treatments are perfect. We have established a simple procedure with microendoscopy-assisted reduction and cannulated screw fixation for the treatment of this disease through a single mini-incision. In this study, we delineated the effects of this surgical approach for patients with PCL tibial avulsion fracture.
We retrospectively reviewed 24 patients with acute PCL tibial avulsion fracture treated via this method from 2004 to 2008. All the patients were implanted with cannulated screws (AO/ASIF, 3.5, 4.0 or 4.5 mm in diameter, 3-4 mm in length) for fixation by microendoscopy. The posterior drawer test (PDT) and KT-2000 arthrometer examination were performed to evaluate knee stability. The Lysholm knee scoring scale and the International Knee Documentation Committee (IKDC) scoring scale were used to assess knee function. Types and rates of complications and radiographic follow-up were reviewed for all cases.
23 of 24 cases achieved knee stability by PDT and KT-2000 examination. The Lysholm's score was improved from 43.8 ± 4.6 to 95.3 ± 3.8. The IKDC evaluation demonstrated an improved function in 17 cases with grade A, 6 with grade B, and 1 with grade C. No relevant complications were experienced by any patient.
Increased stability, functional improvement, and few complications were observed in patients of PCL injury-associated tibial fracture avulsion treated with the microendoscopy-assisted reduction and cannulated screw fixation through a single mini-incision.
治疗后交叉韧带（PCL）损伤相关胫骨撕脱骨折有多种手术入路，包括关节镜辅助手术和后外侧切开手术。然而，这些治疗方法都不是完美的。我们通过单一微创切口，建立了一种微创关节镜辅助复位和空心螺钉固定的简单方法来治疗这种疾病。在这项研究中，我们阐述了这种手术方法治疗 PCL 胫骨撕脱骨折患者的效果。
我们回顾性分析了 2004 年至 2008 年期间采用这种方法治疗的 24 例急性 PCL 胫骨撕脱骨折患者。所有患者均采用微创关节镜下植入空心螺钉（AO/ASIF，直径 3.5、4.0 或 4.5 毫米，长 3-4 毫米）固定。通过后抽屉试验（PDT）和 KT-2000 关节测量仪检查评估膝关节稳定性。采用 Lysholm 膝关节评分和国际膝关节文献委员会（IKDC）评分评估膝关节功能。对所有病例进行并发症的类型和发生率以及影像学随访。
24 例患者中有 23 例通过 PDT 和 KT-2000 检查膝关节稳定。Lysholm 评分从 43.8±4.6 提高到 95.3±3.8。IKDC 评估显示 17 例为 A 级，6 例为 B 级，1 例为 C 级，功能均有改善。所有患者均未出现相关并发症。
通过微创关节镜辅助复位和空心螺钉固定单一微创切口治疗 PCL 损伤相关胫骨撕脱骨折患者，可获得更高的稳定性、更好的功能改善和较少的并发症。
