标题：经关节镜下胫骨双隧道双ETHIBOND线联合Versalok锚钉内固定治疗后交叉韧带胫骨止点撕脱骨折疗效观察

      作者：叶武智，张树峰，高长城    榆林市中医医院骨伤三科，陕西 榆林 719000

      卷次： 2023年34卷8期

      【摘要】 目的 观察经关节镜下胫骨双隧道双 ETHIBOND线联合Versalok锚钉内固定治疗后交叉 韧带(PCL)胫骨止点撕脱骨折的疗效。方法 回顾性分析 2019年 8月至2021年 8月榆林市中医医院骨伤三科收治的80例后交叉韧带胫骨止点撕脱骨折患者的临床诊治资料，根据不同的手术方案分为双ETHIBOND线组(41例，采用经关节镜下胫骨双隧道双 ETHIBOND线固定治疗)和联合 Versalok锚钉组(39例，在对照组的基础上联合Versalok锚钉内固定)。比较两组患者的手术时间、住院时间、术后骨折复位情况、骨折愈合时间及膝关节活动功能变化，并记录两组患者术后并发症发生情况。结果 联合Versalok锚钉组患者的骨折愈合时间为(72.39±9.68) d，短于双ETHIBOND线组的(84.12±10.36) d，差异有统计学意义(P<0.05)。术后2 d经影像学复检，联合Versalok锚钉组患者均复位满意，双ETHIBOND线组出现移位 1例，两组患者术后骨折复位满意率比较差异无统计学意义(P>0.05)。联合Versalok锚钉组术后 1个月、3个月及 6个月的Lysholm评分分别为(69.97±3.84)分、(88.45±5.23)分和(94.34±1.46)分，均高于双ETHIBOND线组的(68.22±3.69)分、(82.24±4.12)分和(90.21±2.37)分，差异有统计学意义(P<0.05)；联合Versalok锚钉组术后 1个月、3个月及 6个月的 IKDC评分分别为(55.21±3.95)分、(86.62±3.12)分和(95.12±1.83)分，均高于双ETHIBOND线组的(53.26±4.12)分、(82.96±2.69)分和(90.11±2.64)分，差异有统计学意义(P<0.05)。两组术后总并发症发生率比较差异无统计学意义(12.20% vs 5.26%，P>0.05)。结论 经关节镜下胫骨双隧道双ETHIBOND线联合Versalok锚钉内固定可有效缩短PCL胫骨止点撕脱骨折患者的骨折愈合速率，改善膝关节功能，提高临床疗效，且安全性较好。
      【关键词】 后交叉韧带；胫骨止点撕脱骨折；关节镜；双隧道；ETHIBOND线；Versalok锚钉
      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350（2023）08—1101—05

Curative effect of knee arthroscopy with double ETHIBOND sutures combined with Versalok anchor internalfixation on tibial avulsion fractures of posterior cruciate ligament.
YE Wu-zhi, ZHANG Shu-feng, GAO Chang-cheng.The Third Department of Orthopedics, Yulin Hospital of Traditional Chinese Medicine, Yulin 719000, Shaanxi, CHINA
【Abstract】 Objective To observe the curative effect of knee arthroscopy with double ETHIBOND suturescombined with Versalok anchor internal fixation on tibial avulsion fractures of posterior cruciate ligament (PCL).Methods The clinical data of 80 patients with tibial insertion avulsion fracture of PCL admitted to the Third Depart-ment of Orthopedics, Yulin Hospital of Traditional Chinese Medicine from August 2019 to August 2021 were retrospec-tively analyzed. According to different surgical methods, they were divided into double ETHIBOND suture group (41cases, knee arthroscopy with double ETHIBOND sutures) and combined Versalok anchor group (39 cases, Versalok an-chor internal fixation on basis of control group). The operation time, length of hospital stay, postoperative fracture reduc-tion, fracture healing time and changes in range of motion were compared between the two groups, and the occurrence ofpostoperative complications in both groups was recorded. Results The fracture healing time in the combined Versalok an-chor group was (72.39±9.68) d, which was significnatly shorter than (84.12±10.36) d in the double ETHIBOND suturegroup (P<0.05). At 2 d after surgery, imaging re-examination showed that there was high satisfaction with fracture reduc-tion in combined Versalok anchor group, while there was 1 case with displacement in double ETHIBOND suture group;there was no significant difference in postoperative fracture reduction between the two groups (P>0.05). At 1, 3, and6 months after surgery, Lysholm scores in the combined Versalok anchor group were (69.97±3.84) points, (88.45±5.23) points, and (94.34±1.46) points, which were significantly higher than (68.22±3.69) points, (82.24±4.12) points,and (90.21±2.37) points in the double ETHIBOND suture group (P<0.05). At 1, 3 and 6 months after surgery, IKDCscores in the combined Versalok anchor group were (55.21±3.95) points, (86.62±3.12) points, and (95.12±1.83) points,which were significnatly higher than (53.26±4.12) points, (82.96±2.69) points, (90.11±2.64) points in the double ET-HIBOND suture group (P<0.05). There was no significant difference in the total incidence of postoperative complica-tions between the two groups (12.20% vs 5.26%, P>0.05). Conclusion Knee arthroscopy with double ETHIBOND su-tures combined with Versalok anchor internal fixation can effectively shorten fracture healing time, improve knee func-tion and clinical curative effect in patients with tibial avulsion fractures of PCL, with good safety.
      【Key words】 Posterior cruciate ligament; Tibial avulsion fracture; Arthroscope; Double tunnel; ETHIBOND su-ture; Versalok anchor