Ding Jing, Wan Lianping, Hou Xiaosheng, Gan Yudong
Orthopedic Center, Kunming General Hospital of Chengdu Military Region, Kunming, Republic of China.
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Republic of China.
J Knee Surg. 2019 Mar;32(3):290-294. doi: 10.1055/s-0038-1641173. Epub 2018 Apr 10.
This study evaluated clinical results of tension band wire fixation technique in the arthroscopic treatment of anterior cruciate ligament (ACL) tibial avulsion fracture. This study included 148 cases of ACL tibial avulsion fracture treated using arthroscopic tension band wire fixation technique. Patients were followed up for 25 to 36 months with an average of 27 months and evaluated in accordance with the International Knee Documentation Committee (IKDC) and Lysholm knee scoring scale. Fractures were united within 3 months after surgery in all cases. During the last follow-up, the anterior drawer, Lachman, and pivot shift tests showed negative, except for eight patients who had a 1-degree positive anterior drawer test. KT-1000 knee stability test showed no anterior instability exceeding 2 mm in 132 patients and 4 mm in 8 patients. In accordance with the IKDC scale, the knees of 132 patients were graded normal, whereas 8 other patients were nearly normal. Lysholm scores before surgery and during the last follow-up were 72.4 ± 3.2 and 97.5 ± 2.2, respectively. Statistically significant differences were observed among the Lysholm scores ( < 0.05). The Tegner scores were 6.5 ± 0.9 before injury and 6.4 ± 0.7 at the last follow-up ( > 0.05). No statistically significant differences between the preinjury and postoperative activity level were observed. All patients were satisfied with the outcomes of operation. Arthroscopic treatment of ACL tibial avulsion fracture by using tension band wire fixation technique ensures fracture healing and restores the stability and function of the joint in most patients. The level of evidence for this study is III.
本研究评估了张力带钢丝固定技术在关节镜治疗前交叉韧带（ACL）胫骨撕脱骨折中的临床效果。本研究纳入了148例采用关节镜张力带钢丝固定技术治疗的ACL胫骨撕脱骨折患者。对患者进行了25至36个月的随访，平均随访27个月，并根据国际膝关节文献委员会（IKDC）和Lysholm膝关节评分量表进行评估。所有病例骨折均在术后3个月内愈合。在末次随访时，除8例患者前抽屉试验为1度阳性外，前抽屉试验、Lachman试验和轴移试验均为阴性。KT-1000膝关节稳定性试验显示，132例患者无超过2 mm的前向不稳定，8例患者无超过4 mm的前向不稳定。根据IKDC量表，132例患者的膝关节评分为正常，另外8例患者接近正常。术前和末次随访时的Lysholm评分分别为72.4±3.2和97.5±2.2。Lysholm评分之间存在统计学显著差异（<0.05）。Tegner评分在受伤前为6.5±0.9，在末次随访时为6.4±0.7（>0.05）。受伤前和术后活动水平之间未观察到统计学显著差异。所有患者对手术结果均满意。采用张力带钢丝固定技术关节镜治疗ACL胫骨撕脱骨折可确保骨折愈合，并在大多数患者中恢复关节的稳定性和功能。本研究的证据等级为III级。
