Verdano Michele Arcangelo, Pellegrini Andrea, Lunini Enricomaria, Tonino Pietro, Ceccarelli Francesco
Clinic of Orthopedics and Traumatology, University of Parma, Parma, Italy.
Unit of Sport Medicine, Loyola University Medical Center, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2013 Dec 14;3(1):e45-8. doi: 10.1016/j.eats.2013.08.016. eCollection 2014 Feb.
The purpose of this technical note and accompanying video is to describe a modified arthroscopic suture fixation technique to treat tibial spine avulsion fractures. Twenty-one patients underwent arthroscopic treatment for tibial spine avulsion with our technique; they were clinically and biomechanically evaluated at 2 years' follow-up and showed optimal clinical and radiographic outcomes. Repair with this arthroscopic technique provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the anterior cruciate ligament: suture methods based on the avulsed bone fragment are technically impossible, but sutures through the base of the ligament itself provide secure fixation, reducing the risks of comminution of the fracture fragment and eliminating the time for hardware removal. This arthroscopic technique restores the length and the integrity of the anterior cruciate ligament and provides a simplified, reproducible method of treating patients, including young patients, with low hardware costs in comparison to sutures using anchors or other hardware.
本技术说明及配套视频的目的是描述一种改良的关节镜下缝合固定技术，用于治疗胫骨棘撕脱骨折。21例患者采用我们的技术接受了关节镜治疗胫骨棘撕脱；在2年随访时对他们进行了临床和生物力学评估，结果显示临床和影像学效果均最佳。采用这种关节镜技术进行修复，通过在前交叉韧带实质内实现关节镜下固定，在治疗胫骨髁间隆起III型和IV型骨折方面具有显著优势：基于撕脱骨块的缝合方法在技术上是不可能的，但通过韧带本身的基部进行缝合可提供可靠的固定，降低骨折块粉碎的风险，并消除取出内固定物的时间。这种关节镜技术恢复了前交叉韧带的长度和完整性，并提供了一种简单、可重复的治疗方法，适用于包括年轻患者在内的患者，与使用锚钉或其他内固定物的缝合相比，硬件成本较低。
