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关节镜下使用带足迹铆钉的超编织缝线治疗青少年前交叉韧带胫骨髁间嵴撕脱骨折

[Ultrabraid SUTURE WITH FOOTPRINT RIVET FOR ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE IN ADOLESCENTS UNDER ARTHROSCOPY].

作者信息

Liang Jinying, Zheng Jiapeng, Ll Qiang, Zhong Shuyu, Chen Minzhen

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Jun;29(6):721-4.

Abstract

OBJECTIVE

To investigate the clinical effects of the Ultrabraid suture with FOOTPRINT rivet by arthroscopic technique for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture.

METHODS

Between May 2011 and December 2013, 19 adolescent patients with ACL tibial eminence avulsion fracture were treated with arthroscopic reduction and fixation by Ultrabraid sutures with FOOTPRINT rivet. There were 13 males and 6 females with an average age of 15.8 years (range, 8-18 years). The left knees were involved in 10 cases and the right knees in 9 cases. The injury causes included traffic accident injury in 8 cases, sport injury in 6 cases, and sprain injury in 5 cases. Three patients had old fractures, and the others had fresh fractures. The results of Lachman test and anterior drawer test were both positive. The International Knee Documentation Committee (IKDC) subject score was 54.2 ± 4.0. Based on Meyers-McKeever classification, there were 3 cases of type II, 10 cases of type III, and 6 cases of type IV.

RESULTS

The operation time was 50-60 minutes (mean, 55.2 minutes). X-ray film showed satisfactory fracture reduction at 1 day after operation. Primary healing of incision was obtained with no infection. Eighteen patients were followed up for 1-3 years (mean, 1.7 years). All fractures healed with smooth joint surface on the X-ray film at 3 months after operation. The results of Lachman test and anterior drawer test were both negative in 17 cases, and the results was negative for anterior drawer test and was weakly positive for Lachman test in 1 case. The IKDC subject score was significantly improved to 96.1 ± 2.1 at last follow-up (t = 34.600, P = 0.000).

CONCLUSION

It could achieve early restoration of knee joint function to treat the ACL tibial eminence avulsion fracture by arthroscopic technique of the Ultrabraid suture with FOOTPRINT rivet because of satisfactory reduction, reliable fixation, small wound, and early rehabilitation.

摘要

目的

探讨采用关节镜技术,使用带FOOTPRINT铆钉的Ultrabraid缝线治疗前交叉韧带(ACL)胫骨髁间嵴撕脱骨折的临床效果。

方法

2011年5月至2013年12月,19例青少年ACL胫骨髁间嵴撕脱骨折患者接受关节镜下复位并用带FOOTPRINT铆钉的Ultrabraid缝线固定治疗。其中男性13例,女性6例,平均年龄15.8岁(8 - 18岁)。左侧膝关节损伤10例,右侧膝关节损伤9例。损伤原因包括交通事故伤8例,运动损伤6例,扭伤5例。3例为陈旧性骨折,其余为新鲜骨折。Lachman试验和前抽屉试验结果均为阳性。国际膝关节文献委员会(IKDC)主观评分为54.2±4.0。根据Meyers - McKeever分类,Ⅱ型3例,Ⅲ型10例,Ⅳ型6例。

结果

手术时间为50 - 60分钟(平均55.2分钟)。术后1天X线片显示骨折复位满意。切口一期愈合,无感染。18例患者随访1 - 3年(平均1.7年)。术后3个月时,所有骨折均愈合,X线片显示关节面光滑。17例患者Lachman试验和前抽屉试验结果均为阴性,1例患者前抽屉试验结果为阴性,Lachman试验结果为弱阳性。末次随访时IKDC主观评分显著提高至96.1±2.1(t = 34.600,P = 0.000)。

结论

采用带FOOTPRINT铆钉的Ultrabraid缝线关节镜技术治疗ACL胫骨髁间嵴撕脱骨折,因其复位满意、固定可靠、伤口小且康复早,可实现膝关节功能的早期恢复。

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