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目的探讨关节镜下经胫骨骨道缝线固定法治疗儿童后交叉韧带胫骨止点撕脱骨折的临床效果。方法 2013年6月至2015年12月期间,采用关节镜下经胫骨骨道不可吸收缝线固定法治疗后交叉韧带胫骨止点撕脱骨折儿童患者18例,男15例(15膝),女3例(3膝),年龄为6~16岁(平均9.3岁)。术后随访观察,通过关节功能评分及影像学方法评估膝关节功能改善和骨折愈合程度等。结果所有患者均获得随访,随访时间6~24个月(平均15.6个月)。所有患者均获得良好复位,术后3个月时骨折全部愈合,膝关节活动度由术前(39.1±14.25)°恢复至(135.28±13.12)°,Lysholm膝关节功能评分由术前(38.8±6.2)分提高至(93.4±5.8)分,IKDC评分由术前(56.3±11.4)分提高至(91.6±5.7)分,差异均具有统计学意义(P<0.01)。末次随访时双侧下肢长度无明显差异,膝关节功能恢复正常。结论关节镜下经胫骨骨道缝线固定法治疗儿童后交叉韧带胫骨止点撕脱骨折,创伤小,复位内固定效果好,有助于减少骺板损伤和恢复膝关节功能。
Objective To investigate the clinical effect of arthroscopic tibial bone suture fixation for tibial avulsion fracture of the posterior cruciate ligament in children. Methods From June 2013 to December 2015, 18 cases of pediatric tibial avulsion fracture of the posterior cruciate ligament were treated with arthroscopic tibial shaft nonabsorbable suture fixation. There were 15 males (15 knees) and 15 females Three patients (3 knees), aged 6 to 16 years (mean, 9.3 years). Postoperative follow-up observation, through the joint function score and imaging methods to assess the improvement of knee joint function and fracture healing. Results All patients were followed up for 6-24 months (average 15.6 months). All patients received a good reduction and all the fractures healed at 3 months after operation. The knee mobility was restored from (39.1 ± 14.25) ° to (135.28 ± 13.12 °) before surgery, and the Lysholm knee function score was improved from 38.8 ± (P <0.01). The IKDC score increased from (56.3 ± 11.4) points to (91.6 ± 5.7) points before surgery and the difference was statistically significant (P <0.01). There was no significant difference in the length of bilateral lower extremities at the final follow-up, and the knee joint function returned to normal. Conclusion Arthroscopic tibial bone suture fixation for the treatment of avulsion fractures of the posterior cruciate ligament tibia in children with small trauma, reduction and internal fixation is effective and can help reduce the epiphyseal plate injury and restore knee function.