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屈髋屈膝位膝关节后内侧横行小切口治疗后交叉韧带胫骨止点撕脱骨折
Hits: 2041   Download times: 1422   Received:June 11, 2014    
作者Author单位UnitE-Mail
兰俊 LAN Jun 丽水市人民医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the People's Hospital of Lishui, Lishui 323000, Zhejiang, China lanjunchina@163.com 
王济纬 WANG Ji-wei 丽水市人民医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the People's Hospital of Lishui, Lishui 323000, Zhejiang, China  
张凯跃 ZHANG Kai-yao 丽水市人民医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the People's Hospital of Lishui, Lishui 323000, Zhejiang, China  
期刊信息:《中国骨伤》2015年28卷,第1期,第48-51页
DOI:10.3969/j.issn.1003-0034.2015.01.012


目的: 评价应用屈髋屈膝位膝关节后内侧横行小切口治疗后交叉韧带胫骨撕脱骨折的方法及疗效.

方法: 对2010年3月至2013年3月应用屈髋屈膝位膝关节后内侧横行小切口切开复位、空心螺钉固定治疗的21例后交叉韧带胫骨撕脱骨折患者进行回顾性分析,男13例,女8 例;年龄 20~56岁,平均35.1岁;交通事故伤11例,坠落伤3例,运动伤4例,重物砸伤3例;伤后至手术时间3 h~9 d,平均3.5 d;后抽屉试验均为阳性.采用膝关节Lysholm评分评价膝关节功能.

结果: 手术过程均顺利,无腘窝血管神经损伤.切口长度5~6 cm,平均5.8 cm.术后检查抽屉试验阴性,复查X线均证实骨折复位.21例均获随访,时间7~23个月,平均12.7个月.骨折均骨性愈合,膝关节Lysholm评分由术前的40.76±9.55提高至末次随访时的95.86±2.33(t=30.07,P=0.000).

结论: 屈髋屈膝位膝关节后内侧横行小切口治疗后交叉韧带胫骨止点撕脱骨折是是简便、安全的手术方法,可有效显露骨折区域,手术创伤小,愈合后瘢痕小,疗效满意.
[关键词]:后交叉韧带  骨折  膝关节
 
Treatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion
Abstract:

Objective: To explore the methods and outcomes of a minimally posteromedial transverse incision in the hip knee flexion for the treatment of tibial avulsion fracture at the insertion of posterior cruciate ligament(PCL).

Methods: Twenty one patients with tibial avulsion fracture at the insertion of PCL treated with a minimally posteromedial transverse incision in the hip knee flexion by cannulated screw fixation from March 2010 to March 2013 were retrospectively analyzed. There were 13 males and 8 females with an average age of 35.1 years old(ranged,20 to 56 years). Eleven cases caused by traffic accident,3 caused by falling,4 caused by sport,3 caused by heavy pounds. The injury duration ranged from 3 hours to 9 days with a mean of 3.5 days. The results of posterior drawer test were positive in all patients. Lysholm score was used to evaluated knee joint function.

Results: All operations were successful without infection,vessel and nerve injuries and all incisions healed by first intention with the mean length of 5.8 cm(ranged,5 to 6 cm). All patients were followed up from 7 to 23 months with an average of 12.7 months. The results of posterior drawer test were negative in all patients. X ray films showed that all fractures healed. The Lysholm score was improved from preoperative 40.76±9.55 to 95.86±2.33 final follow up(t=30.07,P =0.000).

Conclusion: Treatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion with cannulated screw fixation is a better surgical procedure with the advantages of minimal incision,sufficient exposure,effective fixation,small scar and satisfactory effects.
KEYWORDS:Posterior cruciate ligament  Fractures  Knee joint
 
引用本文,请按以下格式著录参考文献:
中文格式:兰俊,王济纬,张凯跃.屈髋屈膝位膝关节后内侧横行小切口治疗后交叉韧带胫骨止点撕脱骨折[J].中国骨伤,2015,28(1):48~51
英文格式:LAN Jun,WANG Ji-wei,ZHANG Kai-yao.Treatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(1):48~51
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