关节镜下“8”字缝线固定治疗前交叉韧带胫骨止点撕脱骨折

目的：研究一种膝关节镜辅助下治疗前交叉韧带胫骨止点撕脱骨折的手术方法及临床疗效。方法：选择19例前交叉韧带胫骨止点撕脱骨折病患（Meyers分型1]：Ⅱ型15例，DI型4例），在膝关节镜下用缝线穿过前交叉韧带，在其前方交叉成“8”字后经胫骨隧道引出缝线，拉紧缝线复位固定骨折块并固定于胫骨前一枚微型钢板上。结果：术后X线检查示撕脱骨折完全复位，19例均获得随访，末次随访膝关节屈伸活动正常，Lachmen试验均为阴性。依据国际膝关节文件编制委员会（IKDC）综合评定，入院时均为D级，术后A级11例，B级8例。术后Lysholm评分（93．95±0．99）分，与术前（27．74±0．45）分比较，差异具有统计学意义（t=61．75，P〈0．05）。结论：关节镜下缝线固定技术治疗MeyersⅡ型、Ⅲ型前交叉韧带胫骨止点撕脱骨折，微创、简捷、疗效确实。

＂8＂ Shape Suture Fixation in Treatment of Avulsion Fracture of Tibial Insertion of Anterior Cruciate Ligament Under Arthroscopy

Objective：To research the surgical method and clinical efficacy in treatment of avnlsion fracture of the tibial insertion of anterior cruciate ligament under arthroscopy. Methods ： 19 cases of patients who got avulsion fracture of the tibial insertion of anterior cruciate ligament （ including Meyers type1] Ⅱ 15 cases, type Ⅲ 4 cases ） were selected. The suture cross into ＂8＂ shape was made after the suture penetrating into anterior cruciate ligament, then leading the suture through the tibial tunnel. The fracture was reset by tension and the suture was just fixed on a mini steel plate in fount of tibia. Results ： Postoperative X-ray examination showed avulsion fracture completely reset. In the final follow-up, all got functional recovery, and Lachmen＇s test （ - ）. According to International Knee Documentation Committee （ IKDC ）comprehensive assessment, all were D grade on admission. A grade 11 cases, B grade 8 cases after surgery. Lysholm score were （ 93.95 ± 0.99 ） compared with the score （ 27.74 ± 0.45 ） before operation. The difference was statistically significant （ t=61.75, P〈0.05 ）. Conclusion ： Suture fixation of posterior cruciate ligament injury and the treatment of tibial avulsion fracture Meyers type Ⅱ and type Ⅲ small incision efficacy are indeed.