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Title: [Arthroscopic treatment of both anterior and posterior cruciate ligament tibial insertion avulsion fractures with suture and absorbable screw double fixation].
Author: Zhao D, Li Y, Jiang Z, Li Y, Zhang J, Wu Z, Wang F, Wang G, He C.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2016 Jul 08; 30(7):822-825. PubMed ID: 29786316.
Abstract:
OBJECTIVE: ?To evaluate the effectiveness of arthroscopic suture and absorbable screw double fixation for both anterior and posterior cruciate ligament avulsion fractures of tibial insertions. METHODS: ?Between June 2006 and September 2013, 8 patients with anterior and posterior cruciate ligament avulsion fractures of the tibial eminence underwent arthroscopic treatment with suture and absorbable screw double fixation. There were 5 males and 3 females, with a mean age of 28.9 years (range, 18-43 years). The causes of injury included traffic accident in 5 cases and falling from height in 3 cases. The time from injury to operation was 3-10 days (mean, 6.2 days). The Lysholm knee score, International Knee Documentation Committee (IKDC) score, and Tegner rating scales were used to evaluated the knee function. RESULTS: ?Primary healing of incision was obtained, without infection or deep vein thrombosis. The mean follow-up period was 42.4 months (range, 24 to 65 months). At 3 months after operation, X-ray films showed good reduction and healing of fracture. The anterior and posterior drawer tests were negative. The knee range of motion was normal (0-125°), and it recovered to preoperative level in 7 cases. The IKDC score, Tegner score, and Lysholm score were significantly improved to 90.4±5.2, 7.5±1.6, and 89.2±3.5 from preoperative 52.1±3.3, 3.3±1.0, and 51.9±3.5 respectively (t=-38.680, P=0.000; t=-39.520, P=0.000; t=-41.150, P=0.000). CONCLUSIONS: ?A combined injury of anterior and posterior cruciate ligament avulsion fractures of tibial insertions is rare. Arthroscopic treatment with suture and absorbable screw double fixation is a useful technique to restore tibial avulsion injuries with well-documented radiographic healing, good clinical outcomes, and low complication rates. 目的: 探讨关节镜下缝线及可吸收螺钉双重固定法治疗前后交叉韧带胫骨侧撕脱骨折的临床疗效。. 方法: 2006年6月-2013年9月，于关节镜下分别使用5号爱惜邦缝线及可吸收螺钉双重固定治疗8例前后交叉韧带胫骨侧撕脱骨折患者。其中男5例，女3例；年龄18～43岁，平均28.9岁。致伤原因：交通事故伤5例，高处坠落伤3例。受伤至手术时间3～10 d，平均6.2 d。术前影像学检查均显示为前后交叉韧带胫骨侧撕脱骨折。术前及末次随访时采用国际膝关节文献委员会（IKDC）评分、Tegner评分和Lysholm评分评价膝关节功能恢复情况。. 结果: 术后患者切口均Ⅰ期愈合，无切口感染、下肢深静脉血栓形成等并发症发生。8例均获随访，随访时间24～65个月，平均42.4个月。术后3个月X线片复查示骨折均愈合，骨折复位良好；前后抽屉试验均呈阴性，关节主被动活动度完全正常（0～125°）。7例患者恢复至伤前活动水平。末次随访时，患者IKDC评分、Tegner评分和Lysholm评分分别为（90.4±5.2）、（7.5±1.6）、（89.2±3.5）分，均较术前[分别为（52.1±3.3）、（3.3±1.0）、（51.9±3.5）分]显著改善，差异有统计学意义（t=-38.680，P=0.000；t=-39.520，P=0.000；t=-41.150，P=0.000）。. 结论: 前后交叉韧带胫骨侧撕脱骨折临床少见。关节镜下缝线及可吸收螺钉双重固定法可同时在镜下对前后交叉韧带止点进行复位固定，操作方便，疗效可靠。.

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