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关节镜下复位并应用缝线桥技术重建足迹区结构治疗前交叉韧带撕脱骨折

[Arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for the treatment of anterior cruciate ligament avulsion fracture].

作者信息

Sun Jin, Zhang Lei, Liu Jin-Song, Zhang Sheng, Li Zhi-Yao, Ma Jia, Liu Xiao-Hua

机构信息

The Forth Department of Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China;

The Forth Department of Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.

出版信息

Zhongguo Gu Shang. 2016 Sep 25;29(9):804-808. doi: 10.3969/j.issn.1003-0034.2016.09.007.

Abstract

OBJECTIVE

To evaluate the preliminary curative effect of arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for anterior cruciate ligament avulsion fracture.

METHODS

From March 2010 to September 2012, 6 patients suffered anterior cruciate ligament avulsion fracture were treated with arthroscopic Suture bridge fixation for anterior cruciate ligament tibial side footprint reconstruction. There were 2 males and 4 females, ranging in age from 14 to 52 years old. There were 2 cases of type III and 4 cases of type IV displaced fractures classified by Meyers-McKeever-Zaricznyj. Preoperative ADT and Lachman tests were positive.

RESULTS

All the patients was follow up more than 2 years. Postoperative ADT and Lachman tests were negative without limitation of knee extension. Postoperative X ray and MRI showed that displaced fracture with a good reduction and union, recovered normal shapeness of ACL. The postoperative Lysholm and IKDC scores at different time points(3 months, 1 year, 2 years after operation) improved significantly comparing with preoperative, and the differences were statistically significant (<0.01).

CONCLUSIONS

Suture Bridge tech reconstructing footprint area structure for ACL avulsion fracture is an effective and safe method, especially for adolescent patients with unclosed epiphysis and comminuted avulsion fracture.

摘要

目的

评估关节镜下复位并利用缝线桥技术重建前交叉韧带撕脱骨折足迹区结构的初步疗效。

方法

2010年3月至2012年9月,对6例前交叉韧带撕脱骨折患者采用关节镜下缝线桥固定技术重建前交叉韧带胫骨侧足迹区。其中男性2例,女性4例,年龄14~52岁。按照Meyers-McKeever-Zaricznyj分型,Ⅲ型2例,Ⅳ型移位骨折4例。术前前抽屉试验(ADT)及Lachman试验均为阳性。

结果

所有患者均获随访2年以上。术后ADT及Lachman试验均为阴性,膝关节伸直无受限。术后X线及磁共振成像(MRI)显示移位骨折复位及愈合良好,前交叉韧带形态恢复正常。术后不同时间点(术后3个月、1年、2年)的Lysholm及国际膝关节文献委员会(IKDC)评分较术前均显著提高,差异有统计学意义(<0.01)。

结论

缝线桥技术重建前交叉韧带撕脱骨折足迹区结构是一种有效、安全的方法,尤其适用于骨骺未闭的青少年患者及粉碎性撕脱骨折患者。

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