Arthroscopic Reduction and Fixation of Comminuted Fracture of Posterior Cruciate Ligament from Tibia Using Suture Anchors through an Posterolateral Portal via Popliteal Fossa_West China Medical Journal

Authors：

YANG Bin , YANG Jun , PENG Zhaohua

Department of Orthopedic, People’s Hospital of Meishan, Meishan, Sichuan 620010, P.R.China;

Corresponding author：

Keywords：

后交叉韧带; 粉碎骨折; 骨内固定术; 关节镜; 锚钉

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【摘要】目的 探讨关节镜辅助下经腘窝小切口应用锚钉固定治疗后交叉韧带胫骨止点粉碎骨折的临床效果。方法 2007年2月-2008年12月对22例急性后交叉韧带胫骨止点骨折患者，采用关节镜辅助下经腘窝小切口切开复位，利用缝合锚钉重建止点，固定治疗后测试交叉韧带的张力和稳定，采用Lysholm膝关节功能评分评定膝关节功能。结果骨折平均愈合时间为6周，平均屈膝活动度（120±3）°。Lysholm膝关节功能评分为（92±2）分。结论关节镜辅助经腘窝小切口锚钉固定治疗后交叉韧带胫骨止点粉碎骨折，可协助诊断关节内韧带及骨折损伤情况，对韧带止点进行重建，操作简便，早期功能锻炼有助于关节功能恢复。
【Abstract】 Objective To explore surgical technique and the results of arthroscopic reduction and fixation for the treatment of comminuted fracture of the posterior cruciate ligament (PCL) from the tibia using suture anchor through an posterolateral portal via popliteal fossa. Methods Twenty-two patients who were operated through an posterolateral portal via popliteal fossa, the fragment was fixed by using suture anchor to reestablish the insertion, test the tension and stabilization of PCL. Lysholm score was used to evaluate the knee function. Results The bone union was confirmed by X-ray films at the 6 weeks postoperatively. The ROM of knee joint relaxation was 120±3°. The Lysholm score was 92±2. Conclusion The displaced fragment of the comminuted fracture of the posterior cruciate ligament from the tibia can be reduced and fixed with the suture anchor arthroscopicly. Using suture anchors demonstrate a reliable and easy to use technique. Operation under arthroscopy helps diagnose and treat other complications inside knee joint. In addition, early functional exercise contributes torapid recovery of knee joint’s function.

Citation： YANG Bin,YANG Jun,PENG Zhaohua. Arthroscopic Reduction and Fixation of Comminuted Fracture of Posterior Cruciate Ligament from Tibia Using Suture Anchors through an Posterolateral Portal via Popliteal Fossa. West China Medical Journal, 2010, 25(8): 1455-1456. doi: Copy

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1. 赵金忠, 蒋圭. 关节镜下缝线固定治疗PCL胫骨止点骨折[J]. 中华创伤杂志, 2003, 19(9): 569-570.
2. Littlejohn SG, Geissler WB. Arthroscopic repair of a posterior cruciate ligament avulsion[J]. Arthroscopy, 1995, 11(2): 235-238.
3. Choi NH, Kim SJ. Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia[J]. Arthroscopy, 1997, 13(6): 759-762.
4. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 第3版, 北京: 人民军医出版社, 2005: 700-703.
5. 赵金忠, 何耀华, 王建华. 关节镜下经双后内侧入路治疗急性后十字韧带胫骨止点撕脱骨折[J]. 中华骨科杂志, 2005, 25(1): 16-20.
6. Logan M, Williams A, Lavelle J, et al. The effect of posterior cruciate ligament deficiency on knee kinematics [J]. Am J Sports Med, 2004, 32(8): 1915-1922.
7. Veselko M, Saciri V. Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer[J]. Arthroscopy, 2003, 19(8): 916-921.
8. Shino K, Nakata K, Mae T, et al. Arthroscopic fixation of tibial bony avulsion of the posterior cruciate ligament[J]. Arthroscopy, 2003, 19(2): E12.
9. 黄迅悟, 孙继桐, 关长勇, 等. 关节镜下治疗后交叉韧带胫骨附着部撕脱骨折[J]. 中华创伤骨科杂志, 2006, 8(1): 91-92.

West China Medical Journal

Arthroscopic Reduction and Fixation of Comminuted Fracture of Posterior Cruciate Ligament from Tibia Using Suture Anchors through an Posterolateral Portal via Popliteal Fossa

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