关节镜下缝线8固定成人前交叉韧带胫骨止点骨折的疗效分析

目的探讨关节镜下缝线8字固定成人前交叉韧带（ACL）胫骨止点骨折的手术技术及疗效,为临床治疗提供参考。方法对2008年1月至2013年1月关节镜下采用缝线8字固定成人ACL胫骨止点骨折的33例患者进行回顾性分析,术后随访12-24个月（平均19个月）,对其进行临床评价,包括前抽屉试验、Lachman试验、轴移试验评价膝关节稳定性,Lysholm评分评价膝关节功能,术后X线片评价骨折复位愈合情况。结果术后X线片示骨折均为解剖复位或近解剖复位。患者切口均Ⅰ期愈合。患者前抽屉试验、Lachman试验及轴移试验均呈阴性。Lysholm评分由术前的（43.4±7.8）分,提高至末次随访时的（92.2±7.1）分,比较差异有统计学意义（t=22.3,P〈0.05）。结论关节镜下缝线8字固定成人ACL胫骨止点骨折具有操作简便易行,创伤小,复位佳,固定牢靠,康复快,功能恢复良好,同时避免二次手术,临床疗效满意。

Clinical outcomes of arthroscopic figure-of-eight fixation for avulsion fractures of tibial insertion of anterior cruciate ligament in adults

Objective To explore the arthroscopic figure-of-eight fixation of anterior cruciate ligament tibial avulsion fractures using sutures in adults.Methods A retrospective analysis was conducted on 33 adults with avulsion fracture of the tibial insertion of the anterior cruciate ligament who were treated with arthroscopic figure-of-eight fixation by sutures from January 2008 to January 2013.The average followup period was 19 months,ranging from 12 to 24 months.The follow-up assessment included anterior drawer test,Lachman test,pivot shift,Lysholm knee score and the radiological evaluation.Results All 33 cases successfully achieved reduction and bone union.The knee function was good.The results of anterior drawer test,Lachman test and pivot shift were negative.The preoperative and final follow-up Lysholm knee scores were（43.4 ± 7.8） and（92.2 ± 7.1） points respectively with statistically significant differenece（t =22.3,P〈0.05）.Conclusion The arthroscopic figure-of-eight fixation for avulsion fractures of the tibial insertion of the anterior cruciate ligament using sutures is minimally invasive and convenient with satisfactory reduction and fixation,which can benefit the posoperative rehabilitation.It can avoid reoperation and achieve excellent results.