中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (30): 5697-5700.doi: 10.3969/j.issn.1673-8225.2011.30.045

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    

Tibial-inlay技术重建合并胫骨干骨折膝关节后交叉韧带断裂8例

张义龙，李  宁，李志怀，刘建丰，宋有鑫，孙志杰   

  1. 承德医学院附属医院骨外一科，河北省承德市  067000
  • 收稿日期:2011-03-30 修回日期:2011-04-29 出版日期:2011-07-23 发布日期:2011-07-23
  • 通讯作者: 李志怀，副主任医师，承德医学院附属医院骨外一科，河北省承德市 067000 lizhihuai2971@163.com
  • 作者简介:张义龙★，男，1978年生，河北省深泽县人，汉族，2001年河北医科大学毕业，硕士，主治医师，主要从事骨与关节损伤方面的研究。 zhangyilong267@126.com
  • 基金资助:

    承德市科技局指导计划项目(200922077)：自体骨髓移植在腱-骨愈合中的作用；承德市科技局指导计划项目(200721064)：关节镜下Inlay法重建膝后交叉韧带的临床研究。

Tibial-inlay technique used in reconstruction of posterior cruciate ligament with concomitant ipsilateral tibial shaft fracture in 8 cases

Zhang Yi-long, Li Ning, Li Zhi-huai, Liu Jian-feng, Song You-xin, Sun Zhi-jie   

  1. Department of Orthopedics, the Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
  • Received:2011-03-30 Revised:2011-04-29 Online:2011-07-23 Published:2011-07-23
  • Contact: Li Zhi-huai, Associate chief physician, Department of Orthopedics, the Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China lizhihuai2971@163.com
  • About author:Zhang Yi-long★, Master, Attending physician, Department of Orthopedics, the Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China zhangyilong267@126.com
  • Supported by:

    the Guiding Plan of Chengde Science and Technology Bureau, No. 200922077*; 200721064*

PDF

256

被引次数

5

摘要：

背景：胫骨干骨折伴有同侧的后交叉韧带损伤在行内固定后，行经胫骨隧道技术重建后叉韧带时常会引起金属内固定物与胫骨隧道发生冲突，使内固定物应用受到一定限制。
目的：评估Tibial-inlay技术重建合并胫骨干骨折的膝关节后交叉韧带效果。
方法：选择胫骨干骨折合并同侧后交叉韧带断裂患者8例，于胫骨骨折置入金属植入物内固定后1~6个月在关节镜辅助下行Tibial-inlay技术重建后交叉韧带，重建前、随访时记录膝关节Lysholm功能评分及胫骨后移程度。
结果与结论：随访12~24个月，重建前患侧胫骨后移10~15 mm者 5例，>15 mm 者3例；末次随访时< 5 mm者 6例，5~10 mm 者2例；末次随访Lysholm膝关节功能评分由重建前的63.50±5.83提高到87.50±2.33，差异有显著性意义(P < 0.05)。表明Tibial-inlay技术重建胫骨干骨折合并后交叉韧带损伤具有不受胫骨近端骨隧道的影响，对胫骨内固定干扰小，固定可靠的优点。

关键词: 膝关节, 后交叉韧带, Tibial-inlay技术, 关节镜, 骨折

Abstract:

BACKGROUND: The reconstruction of posterior cruciate ligament (PCL) by tibial tunnel method is limited in treating PCL tear with concomitant ipsilateral tibial shaft fracture which is operated by internal fixation firstly, because there is the internal fixation in the proximal tibia, which can interfere with the making of tibial tunnel.
OBJECTIVE: To evaluate the Tibial-inlay technique effects on reconstruction of PCL combined with concomitant ipsilateral tibial shaft fracture.
METHODS: Eight knees with PCL tear and concomitant ipsilateral tibial shaft fracture in 8 patients were verified with physical examination, medical image and arthroscopy. All the damaged PCLs were reconstructed with allograft tendons by Tibial-inlay technique under arthroscopy 1-6 months after the first internal fixation. The instability degree of post draw test and the Lysholm score of the knees were recorded before operations and at follow-up.
RESULTS AND CONCLUSION: All of them were followed up for 12 to 24 months. The tibial retropositions of 5 cases were from 10 mm to 15 mm, and those of 3 cases were more than 15 mm before reconstructions. The tibial retropositions of 6 cases were no more than 5 mm, and those of 2 cases were from 5 mm to 10 mm at the final follow-up. The Lysholm score was remarkably improved from 63.50±5.83 preoperatively to 87.50±2.33 at follow-up (P < 0.05). The reconstruction of PCL by Tibial-inlay technique, with regard to PCL tear and concomitant ipsilateral tibial shaft fracture, has advantages of non-limitation by tunnel of proximal tibia, no interference to internal fixation of tibia and reliable satisfactory outcome.

中图分类号: