关节镜下空心螺钉固定治疗后交叉韧带胫骨止点撕脱骨折

目的探讨关节镜下后内侧入路中空螺钉固定治疗后交叉韧带胫骨止点撕脱性骨折的手术技巧及疗效。方法对15例后交叉韧带胫骨止点撕脱性骨折行关节镜下复位经后内侧入路,克氏针临时固定,经克氏针置入单枚带垫片直径4.5 mm中空钛质螺钉固定。结果手术时间40～82 min,平均55 min。随访6～24个月,平均15个月。术后6周,所有骨折均获愈合,未出现骨折移位。无窝部神经、血管损伤并发症。所有患者均无屈伸膝活动受限,仅1例患者后抽屉试验弱阳性。术后半年Lysholm膝关节功能评分89～96分,平均92.5分。结论关节镜下通过后内侧入路带垫片中空螺钉治疗后交叉韧带胫骨止点撕脱性骨折,操作方便、安全,效果可靠。

Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament with Canulated Screw Fixation Technique

Objective To explore the surgical technique and clinical results of arthroscopic treatment of tibial avulsion fracture of the posterior cruciate ligament(PCL) with screw fixation technique through posteromedial approach.Methods We treated 15 cases of acute PCL tibial avulsion fracture arthroscopically through posteromedial approach.The PCL and avulsion bony fragment was fixed with 4.5 mm canulated screw.The patients were followedup for more than 6 months and were evaluated according to the Lysholm scales.Results The operation time was between 40 to 82 minutes with the average of 55 minutes.All the patients were followed up for 6～24 months with the average time of 15 months.All the patients were healed without displacement.Neithter nerve nor vessel complications were found.The knee could extend and flex freely in all patients except one patient with posterior draw experiment weakly positive.89～96 points,averaged 92.5 points,were gotten with Lysholm knee score after half a year.Conclusion The technique using canulated screw to fix the avulsion fracture in tibia avulsion fracture of posterior cruciate ligament under arthroscope is convenient and safe with satisfactory effect.