【摘要】 目的 探討關(guān)節(jié)鏡輔助下經(jīng)腘窩小切口應(yīng)用錨釘固定治療后交叉韌帶脛骨止點(diǎn)粉碎骨折的臨床效果。 方法 2007年2月-2008年12月對(duì)22例急性后交叉韌帶脛骨止點(diǎn)骨折患者，采用關(guān)節(jié)鏡輔助下經(jīng)腘窩小切口切開復(fù)位，利用縫合錨釘重建止點(diǎn)，固定治療后測(cè)試交叉韌帶的張力和穩(wěn)定，采用Lysholm膝關(guān)節(jié)功能評(píng)分評(píng)定膝關(guān)節(jié)功能。 結(jié)果 骨折平均愈合時(shí)間為6周，平均屈膝活動(dòng)度（120±3）°。Lysholm膝關(guān)節(jié)功能評(píng)分為（92±2）分。 結(jié)論 關(guān)節(jié)鏡輔助經(jīng)腘窩小切口錨釘固定治療后交叉韌帶脛骨止點(diǎn)粉碎骨折，可協(xié)助診斷關(guān)節(jié)內(nèi)韌帶及骨折損傷情況，對(duì)韌帶止點(diǎn)進(jìn)行重建，操作簡(jiǎn)便，早期功能鍛煉有助于關(guān)節(jié)功能恢復(fù)。
【Abstract】 Objective To explore surgical technique and the results of arthroscopic reduction and fixation for the treatment of comminuted fracture of the posterior cruciate ligament (PCL) from the tibia using suture anchor through an posterolateral portal via popliteal fossa. Methods Twenty-two patients who were operated through an posterolateral portal via popliteal fossa, the fragment was fixed by using suture anchor to reestablish the insertion, test the tension and stabilization of PCL. Lysholm score was used to evaluate the knee function. Results The bone union was confirmed by X-ray films at the 6 weeks postoperatively. The ROM of knee joint relaxation was 120±3°. The Lysholm score was 92±2. Conclusion The displaced fragment of the comminuted fracture of the posterior cruciate ligament from the tibia can be reduced and fixed with the suture anchor arthroscopicly. Using suture anchors demonstrate a reliable and easy to use technique. Operation under arthroscopy helps diagnose and treat other complications inside knee joint. In addition, early functional exercise contributes torapid recovery of knee joint’s function.
引用本文： 楊彬,楊軍,彭朝華. 關(guān)節(jié)鏡輔助經(jīng)腘窩小切口錨釘固定治療后交叉韌帶脛骨止點(diǎn)粉碎骨折. 華西醫(yī)學(xué), 2010, 25(8): 1455-1456. doi: 復(fù)制
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- 1. 趙金忠, 蔣圭. 關(guān)節(jié)鏡下縫線固定治療PCL脛骨止點(diǎn)骨折[J]. 中華創(chuàng)傷雜志, 2003, 19(9): 569-570.
- 2. Littlejohn SG, Geissler WB. Arthroscopic repair of a posterior cruciate ligament avulsion[J]. Arthroscopy, 1995, 11(2): 235-238.
- 3. Choi NH, Kim SJ. Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia[J]. Arthroscopy, 1997, 13(6): 759-762.
- 4. 胥少汀, 葛寶豐, 徐印坎. 實(shí)用骨科學(xué)[M]. 第3版, 北京: 人民軍醫(yī)出版社, 2005: 700-703.
- 5. 趙金忠, 何耀華, 王建華. 關(guān)節(jié)鏡下經(jīng)雙后內(nèi)側(cè)入路治療急性后十字韌帶脛骨止點(diǎn)撕脫骨折[J]. 中華骨科雜志, 2005, 25(1): 16-20.
- 6. Logan M, Williams A, Lavelle J, et al. The effect of posterior cruciate ligament deficiency on knee kinematics [J]. Am J Sports Med, 2004, 32(8): 1915-1922.
- 7. Veselko M, Saciri V. Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer[J]. Arthroscopy, 2003, 19(8): 916-921.
- 8. Shino K, Nakata K, Mae T, et al. Arthroscopic fixation of tibial bony avulsion of the posterior cruciate ligament[J]. Arthroscopy, 2003, 19(2): E12.
- 9. 黃迅悟, 孫繼桐, 關(guān)長(zhǎng)勇, 等. 關(guān)節(jié)鏡下治療后交叉韌帶脛骨附著部撕脫骨折[J]. 中華創(chuàng)傷骨科雜志, 2006, 8(1): 91-92.