關節鏡輔助經腘窩小切口錨釘固定治療后交叉韌帶脛骨止點粉碎骨折_《華西醫學》

作者：

楊彬 , 楊軍 , 彭朝華

眉山市人民醫院骨科（四川眉山，620010）;

關鍵詞：

后交叉韌帶粉碎骨折骨內固定術關節鏡錨釘

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【摘要】目的 探討關節鏡輔助下經腘窩小切口應用錨釘固定治療后交叉韌帶脛骨止點粉碎骨折的臨床效果。方法 2007年2月-2008年12月對22例急性后交叉韌帶脛骨止點骨折患者，采用關節鏡輔助下經腘窩小切口切開復位，利用縫合錨釘重建止點，固定治療后測試交叉韌帶的張力和穩定，采用Lysholm膝關節功能評分評定膝關節功能。結果骨折平均愈合時間為6周，平均屈膝活動度（120±3）°。Lysholm膝關節功能評分為（92±2）分。結論關節鏡輔助經腘窩小切口錨釘固定治療后交叉韌帶脛骨止點粉碎骨折，可協助診斷關節內韌帶及骨折損傷情況，對韌帶止點進行重建，操作簡便，早期功能鍛煉有助于關節功能恢復。
【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. 關節鏡輔助經腘窩小切口錨釘固定治療后交叉韌帶脛骨止點粉碎骨折. 華西醫學, 2010, 25(8): 1455-1456. doi: 復制

1.	趙金忠, 蔣圭. 關節鏡下縫線固定治療PCL脛骨止點骨折[J]. 中華創傷雜志, 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. 實用骨科學[M]. 第3版, 北京: 人民軍醫出版社, 2005: 700-703.
5.	趙金忠, 何耀華, 王建華. 關節鏡下經雙后內側入路治療急性后十字韌帶脛骨止點撕脫骨折[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, 關長勇, 等. 關節鏡下治療后交叉韌帶脛骨附著部撕脫骨折[J]. 中華創傷骨科雜志, 2006, 8(1): 91-92.

1. 趙金忠, 蔣圭. 關節鏡下縫線固定治療PCL脛骨止點骨折[J]. 中華創傷雜志, 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. 實用骨科學[M]. 第3版, 北京: 人民軍醫出版社, 2005: 700-703.
5. 趙金忠, 何耀華, 王建華. 關節鏡下經雙后內側入路治療急性后十字韌帶脛骨止點撕脫骨折[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, 關長勇, 等. 關節鏡下治療后交叉韌帶脛骨附著部撕脫骨折[J]. 中華創傷骨科雜志, 2006, 8(1): 91-92.

《華西醫學》

關節鏡輔助經腘窩小切口錨釘固定治療后交叉韌帶脛骨止點粉碎骨折

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《華西醫學》

關節鏡輔助經腘窩小切口錨釘固定治療后交叉韌帶脛骨止點粉碎骨折

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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