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可调环皮质纽扣固定术治疗后交叉韧带急性胫骨撕脱骨折的临床效果良好。

Adjustable-Loop Cortical Button Fixation Results in Good Clinical Outcomes for Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament.

作者信息

Zhu YiRan, Yuan TangBo, Cai Dawei, Tao Jiachun, Dong Jiachun, Hu Bo, Qin Jian

机构信息

Sir Run Run Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Arthrosc Sports Med Rehabil. 2023 Feb 4;5(2):e307-e313. doi: 10.1016/j.asmr.2022.11.012. eCollection 2023 Apr.

Abstract

PURPOSE

To evaluate the clinical outcomes for arthroscopic treatment of acute posterior cruciate ligament (PCL) avulsion fractures with adjustable-loop cortical button fixation device.

METHODS

Patients with PCL tibial avulsion fractures treated with an adjustable-loop cortical button fixation device between October 2019 and October 2020 were retrospectively identified. Patients with type 1 were treated using plaster fixation as a conservative treatment, whereas patients with type 2 and 3 with displacement were treated using an arthroscopic adjustable-loop cortical button. Operating time, incision recovery, complications, and postoperative fracture healing time were monitored. All patient follow-up was done at 12 months' postoperatively. Lysholm Knee Score and the International Knee Documentation Committee score were used to assess knee function.

RESULTS

A total of 30 patients were included in the study (20 male/10 female; mean age 45.5 years, range 35-68 years). The mean operative time was 67.5 minutes (range: 50-90 minutes). The postoperative incision healed at stage A without complications, such as medically induced vascular nerve injury, intra-articular hematoma, or infection. All 30 patients were tracked postoperatively for 12 to 14 months, with a mean follow-up period of 12.6 months. The Lysholm knee function score was 45.93 ± 6.15 before surgery and 87.10 ± 3.71 at 12 months after surgery, and the International Knee Documentation Committee score was 19.27 ± 4.40 before surgery and 95.47 ± 1.87 at 12 months after surgery, with a statistically significant difference.

CONCLUSIONS

The treatment of PCL avulsion fractures with arthroscopic adjustable-loop cortical button fixation is easy to perform and shows good clinical results in our study.

LEVEL OF EVIDENCE

IV, therapeutic case series.

摘要

目的

评估采用可调节环皮质纽扣固定装置关节镜治疗急性后交叉韧带(PCL)撕脱骨折的临床疗效。

方法

回顾性纳入2019年10月至2020年10月期间采用可调节环皮质纽扣固定装置治疗的PCL胫骨撕脱骨折患者。1型患者采用石膏固定作为保守治疗,而2型和3型有移位的患者采用关节镜下可调节环皮质纽扣治疗。监测手术时间、切口恢复情况、并发症及术后骨折愈合时间。所有患者均在术后12个月进行随访。采用Lysholm膝关节评分和国际膝关节文献委员会评分评估膝关节功能。

结果

本研究共纳入30例患者(男20例/女10例;平均年龄45.5岁,范围35 - 68岁)。平均手术时间为67.5分钟(范围:50 - 90分钟)。术后切口甲级愈合,未出现医源性血管神经损伤、关节内血肿或感染等并发症。30例患者术后均随访12至14个月,平均随访时间为12.6个月。术前Lysholm膝关节功能评分为45.93±6.15,术后12个月为87.10±3.71;术前国际膝关节文献委员会评分为19.27±4.40,术后12个月为95.47±1.87,差异有统计学意义。

结论

在本研究中,采用关节镜下可调节环皮质纽扣固定治疗PCL撕脱骨折操作简便,临床效果良好。

证据级别

IV,治疗性病例系列。

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