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| Clinical Comparative Study of Two Methods (Arthroscopy and Nonoperation) in Treatment of Posterior Cruciate Ligament Inferior Insertion Avulsion Fracture |
| JIANG Zu-kang, ZHOU Hong-xing |
| Pingdingshan Medical District Second Department of Orthopedics, The 989th Hospital of Chinese People Liberation Army Joint Logistics Support Force, Pingdingshan 467000, Henan, China |
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Abstract 【Objective】To explore the clinical comparative study of the treatment of posterior cruciate ligament (PCL) inferior insertion avulsion fracture by arthroscopic suture fixation and nonoperation. 【Methods】The clinical data of 62 (Meyers Classification:Ⅱ、Ⅲ) patients with posterior crucial ligament inferior insertion avulsion fracture in our department from September 2013 to May 2018 were included in the retrospective study. They were divided into two groups randomly. The observation group included 32 patients (20 male cases and12 female cases) with PCL inferior insertion avulsion fracture treated with suture fixation by arthroscopy, while the control group contained 30 patients (17 male cases and 13 female cases). The healing time, tibial displacement (posterior drawer test: PDT), the Lysholm knee score, the hospital special surgery knee score (HSS) of both groups were compared between the two groups. 【Results】Both groups of patients were followed up for 6-24 months with average of (15.7±1.26) months. Results showed that 3 cases of non-healing by surgery in the control group nonunion who needed reoperation. The healing time of the observation group was significantly shorter than that of the control group (P<0.05), PDT grade, Lysholm score and HSS in the observation group were superior to the control group. 【Conclusion】The arthroscopic suture fixation of PCL inferior insertion avulsion fracture (Meyers Classification:Ⅱ、Ⅲ) is more effective than nonoperative treatment, which has higher stability and more improves joint motion function.
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Received: 22 January 2021
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[1] 李彬, 王延芳, 邱闯, 等. 前交叉韧带部分断裂后保守治疗与关节镜下射频修整术的对比研究[J].山西医药杂志, 2016,45(10):1129-1132.
[2] 陈百成, 高石军, 王晓峰,等. 关节镜下股骨单隧道与双隧道重建后十字韧带的疗效分析[J].中华骨科杂志, 2004,24(3):131.
[3] AMBRA L F, FRANCTOZI G E, WEMECK L G, et al. Posteromedial versus direct posterior approach for posterior cruciate ligament reinsertion[J].Orthopedics,2016,39(5):e1024-e1027.
[4] 张华, 李贵山. 关节镜下交叉韧带重建手术22例临床分析[J].中华实用诊断与治疗杂志,2015,29(8):800-801.
[5] HUANG W, CONG X,RAHUL M.et al. Anterior arthroscopic-assisted fixation of posterior cruciate ligament avulsion fracture[J].Eur J Med Res,2015,20(2):88.
[6] 林义才, 罗高斌, 罗颖丽, 等. 关节镜下与切开固定治疗后交叉韧带胫骨止点骨折的比较[J].中国矫形外科杂志, 2019,27(8):673-677.
[7] VELLIOS E E, JONES K J, MCALLSTER D R. Open tibial inlay PCL reconstruction: surgical technique and clinical outcomes[J].Curr Rev Musculoskelet Med,2018,11(2):316-319.
[8] YOON J R, PARK C D, LEE D H. Arthroscopic suture bridge fixation technique with multiple crossover ties for posterior cruciate ligament tibial avulsion fracture[J].Knee Surg Sports Traumatol Arthrosc,2018,26(3):912-918.
[9] SABAT D, JAIN A, KUMAR V. Displaced posterior cruciate ligament avulsion fractures: a retrospective comparative study between open posterior approach and arthroscopic single-tunnel suture fixation[J].Arthroscopy,2016,32(1):44-53.
[10] DOMNICK C, KOSTER C, RANK F, et al. Biomechanical properties of different fixation techniques for posterior cruciate ligament avulsion fractures[J].Arthroscopy,2016,32(6):1065-1071.
[11] 李小磊, 魏鹏, 邱忠鹏. 关节镜下两种固定方式治疗前交叉韧带胫骨止点撕脱骨折的临床研究[J].中国内镜杂志, 2018,24(2):38-42.
[12] 郭艳波, 肖毅. 关节镜下不可吸收缝线结合Endobutton纽扣钢板治疗胫骨髁间嵴撕脱骨折[J].临床骨科杂志, 2019,22(4):508.
[13] 姚彦斌, 任民, 李慎松, 等. 关节镜下缝线双排缝合交叉穿隧道固定前交叉韧带胫骨止点撕脱骨折[J].临床骨科杂志, 2018,21(6):755.
[14] 赵玲, 李海清, 张韶辉, 等. 后交叉韧带撕裂的典型临床特征分析及关节镜手术与保守治疗的疗效比较[J].中国内镜杂志, 2017,23(11):51-55. |
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2021, Vol. 38 
