Zhu Botao, Dong Peilong, Tang Xiaobo, Li Zhiyun, Wang Youhua
Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong Jiangsu, 226001, P. R. China.
Department of Orthopedics, Jianhu Clinical Medical College of Yangzhou University, Yancheng Jiangsu, 224700, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jun 15;37(6):658-662. doi: 10.7507/1002-1892.202303026.
To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults.
Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing.
All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( =23.167, 0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( <0.05).
For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.
探讨关节镜下经单骨隧道缝线捆绑固定治疗成人后交叉韧带（PCL）胫骨止点骨折的疗效。
2019年10月至2021年10月，对16例PCL胫骨止点骨折患者采用关节镜下经单骨隧道缝线捆绑固定治疗。其中男11例，女5例，平均年龄41.1岁（26～58岁）。骨折原因：交通事故伤12例，运动伤4例。伤后至手术时间2～10天，平均6.0天。骨折按Meyers-McKeever分型：Ⅱ型4例，Ⅲ型9例，ZaricznyiⅣ型3例。后抽屉试验：Ⅰ级2例，Ⅱ级7例，Ⅲ级7例。合并外侧副韧带损伤3例，半月板损伤2例。采用视觉模拟评分法（VAS）、Lysholm评分、国际膝关节文献委员会（IKDC）评分及膝关节活动度评估膝关节功能；采用后抽屉试验及膝关节稳定性测试仪（Kneelax 3）评估膝关节稳定性；采用X线片评估骨折复位及愈合情况。
术后所有切口均一期愈合，无切口感染、腘窝神经血管损伤及下肢深静脉血栓形成。所有患者均获随访，时间6～12个月，平均10个月。术后6个月X线片显示骨折均获骨性愈合。后抽屉试验：0级11例，Ⅰ级4例，Ⅱ级1例，与术前比较差异有统计学意义（ =23.167， 0.001）。VAS评分、Lysholm评分、IKDC评分、膝关节活动度及Kneelax3检查结果与术前比较均明显改善（ <0.05）。
对于成人PCL胫骨止点骨折患者，关节镜下经单骨隧道缝线捆绑固定具有创伤小、骨折复位好、固定可靠、并发症少等优点，患者膝关节功能恢复良好。
