前交叉韧带；胫骨止点；撕脱骨折；关节镜；固定_

关节镜下三维固定修复膝前交叉韧带胫骨止点撕脱骨折

http://www.100md.com 《中华现代外科学杂志》 2006年第5期

前交叉韧带；胫骨止点；撕脱骨折；关节镜；固定,,前交叉韧带；胫骨止点；撕脱骨折；关节镜；固定,【摘要】,【关键词】,1资料与方法,2结果,3讨论

     【摘要】 目的探讨关节镜下修复膝前交叉韧带胫骨止点撕脱骨折的固定方法及疗效。方法 1999年5月～2003年7月，共完成镜下修复固定32例，男22例，女10例，新鲜骨折24例，陈旧性骨折8例。应用立体骨隧道导向器，镜下携线2次平行穿越前交叉韧带基底部，经骨折块两侧骨隧道，分别诱导钢丝及PDS线穿越骨隧道-前交叉韧带基底部-骨隧道，在骨隧道外口将PDS线拉紧打结，然后拧紧钢丝固定，完成骑跨式三维固定法。结果 27例获得随访，随访时间6～36个月，平均12.8个月，据Lysholms评价标准，膝关节功能从术前的45分提高到术后的98分。结论本操作通过穿越前交叉韧带的三维固定，固定可靠、骨折块不易旋转、术后功能恢复快，是值得临床推广的微创修复术式。

    【关键词】 前交叉韧带；胫骨止点；撕脱骨折；关节镜；固定

    Threedimensional fixation of the avulsion fracture of ACL tibial insertion by arthroscopy

    JIANG Xin,GUO Yongzhi,LI Hanxiu,et al.Orthopaedic Department,Weifang Peoples Hospital,Shandong 261041,China

    【Abstract】 Objective To explore the arthroscopic fixation of the avulsion fracture of ACL tibial insertion.Methods 16 cases of the avulsion fracture of ACL tibial insertion were fixed 3dimensionally with absorbable suture and wire pulled out through fundus of ACL and bone tunnels arthroscopically.The suture and wire were drew tight and tied a knot.Results The followup study carried out in 27 cases was 8.6 months,(ranged from 6～24 months) According to Lysholm scale,the mean score of the knee function was improved from 45 preoperatively to 98 postoperatively.Conclusion Threedimensional fixation by arthroscopy provides an effective and minimally invasive method for the avulsion fracture of ACL tibial insertion. ......

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