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Title: [Early effectiveness of arthroscopic three-point suture technique in treatment of anterior cruciate ligament tibial eminence avulsion fracture].
Author: Wang W, Fang K, Lin S, Wu G, Chen S.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2019 Jul 15; 33(7):860-864. PubMed ID: 31298004.
Abstract:
OBJECTIVE: To investigate the early effectiveness of three-point suture technique in treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture by arthroscopy. METHODS: Between January 2016 and December 2017, 12 patients with ACL tibial eminence avulsion fractures underwent arthroscopic fixation of avulsion fractures with Ethibon suture using three-point suture technique. There were 9 males and 3 females, with an average of 36.4 years (range, 18-50 years). The fracture caused by traffic accident in 10 cases and sports in 2 cases. Among them, 1 patient was old fracture and 11 was fresh fracture. According to the modified Meyers-McKeever classification criteria, the fractures were rated as type Ⅲ in 7 cases and type Ⅳ in 5 cases. There were 2 cases of medial collateral ligament injury and medial meniscus injury. The preoperative International Knee Documentation Committee (IKDC) score was 37.9±4.7 and Lysholm score was 46.0±3.7. RESULTS: All operations completed smoothly. The operation time was 45-70 minutes (mean, 61.3 minutes). The incisions healed by first intention in all patients. The hospitalization stays ranged from 4 to 9 days (mean, 5 days). All patients were followed up 3-20 months (mean, 9.3 months). The anterior drawer test, Lachman test, and axis shift test in all patients were negative after operation. At last follow-up, the IKDC score was 89.7±2.5 and Lysholm score was 90.2±1.9, which were significantly higher than those before operation ( t=-30.94, P=0.00; t=-33.03, P=0.00). At last follow-up, the X-ray films showed 9 cases of fracture anatomical reduction and 3 cases of almost anatomical reduction, and 12 cases of fracture healing. CONCLUSION: For ACL tibial eminence avulsion fracture, arthroscopic three-point suture technique can effectively restore the stability of knee joint and obtain satisfactory early effectiveness. 目的: 探讨关节镜下运用 3 点缝合技术固定治疗前交叉韧带（anterior cruciate ligament，ACL）胫骨止点撕脱骨折的早期疗效。. 方法: 2016 年 1 月—2017 年 12 月，收治 12 例 ACL 胫骨止点撕脱骨折患者。男 9 例，女 3 例；年龄 18～50 岁，平均 36.4 岁。致伤原因：交通事故伤 10 例，运动损伤 2 例。左侧 5 例，右侧 7 例。陈旧性骨折 1 例，新鲜骨折 11 例。根据改良 Meyers-McKeever 分型标准：Ⅲ型 7 例，Ⅳ型 5 例。合并内侧副韧带损伤、内侧半月板损伤 2 例。国际膝关节文献委员会（IKDC）评分为（37.9±4.7）分，Lysholm 评分为（46.0±3.7）分。关节镜下以 Ethibon 缝线采用 3 点缝合技术固定撕脱骨折。. 结果: 患者均顺利完成手术；手术时间 45～70 min，平均 61.3 min。手术切口均Ⅰ期愈合。术后住院时间 4～9 d，平均 5 d。患者均获随访，随访时间 3～20 个月，平均 9.3 个月。术后前抽屉试验、Lachman 试验及轴移试验均为阴性。末次随访时，IKDC 评分为（89.7±2.5）分，Lysholm 评分为（90.2±1.9）分，均较术前明显提高（ t=–30.94， P=0.00； t=–33.03， P=0.00）。末次随访时，X 线片复查示骨折解剖复位 9 例、接近解剖复位 3 例，12 例骨折均达骨性愈合。. 结论: 采用关节镜下 3 点缝合技术固定治疗 ACL 胫骨止点撕脱骨折，可有效恢复膝关节稳定性，早期疗效满意。.

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