METHODS: Minors who underwent arthroscopic reduction and modified suture bridge fixation of ACL tibial avulsion fracture between January 2018 and January 2022 were retrospectively analyzed. Postoperative MRI and X-ray examinations were performed to evaluate the presence of epiphyseal plate injury and fracture healing. Moreover, KT-1000 side-to-side difference, Lachman test, range of motion (ROM), the subjective Knee score of the International Knee Documentation Committee (IKDC), Lysholm Knee score, and Tegner activity grade score were evaluated preoperatively and at the minimum 1-year follow-up visit.
RESULTS: A total of 16 participants met the inclusion criteria. They had a mean age of 12.6 years (range, 9-16 years); mean time to surgery, 6.9 days (range, 2-13 days) and had a minimum of 12 months clinical follow-up (mean, 25.4 months; range, 12-36 months) after surgery. Postoperative radiographs and MRI showed no injury to the epiphyseal plate, optimal reduction immediately after the operation, and bone union within three months in all patients. All of the following showed significant improvements (pre- vs. postoperatively): mean KT-1000 side-to-side difference (8.6 vs. 1.5; p < 0.05), Lachman tests (2 grade 9 and 3 grade 7 vs. 0 grade 12 and 1 grade 4; p < 0.05), IKDC subjective score (48.3 vs. 95.0; p < 0.05), mean Lysholm score (53.9 vs. 92.2; p < 0.05), mean Tegner activity score (3.2 vs. 8.3; p < 0.05) and mean ROM (42.9°vs 133.1°; p < 0.05).
CONCLUSIONS: Arthroscopic reduction and modified suture bridge fixation for ACL tibial avulsion fracture is a dependable and recommended treatment that can effectively restore the stability and function of the knee and is worthy of clinical promotion.
方法:对2018年1月至2022年1月行关节镜下复位改良缝合桥固定治疗ACL胫骨止点撕脱性骨折的未成年人进行回顾性分析。术后进行MRI和X线检查以评估骨phy板损伤和骨折愈合的存在。此外,KT-1000侧面差异,拉赫曼测试,运动范围(ROM),国际膝关节文献委员会(IKDC)的主观膝关节评分,Lysholm膝盖得分,术前和至少1年随访时评估Tegner活动等级评分。
结果:共有16名参与者符合纳入标准。他们的平均年龄为12.6岁(范围,9-16岁);平均手术时间,6.9天(范围,2-13天),并进行了至少12个月的临床随访(平均,25.4个月;范围,12-36个月)手术后。术后X线片和MRI显示骨phy板无损伤,手术后立即进行最佳还原,和骨愈合在三个月内所有患者。以下各项均显示出显着的改善(前与术后):平均KT-1000左右差异(8.6vs.1.5;p<0.05),拉赫曼测试(2年级9和3年级7vs.0级12级和1级4级;p<0.05),IKDC主观评分(48.3vs.95.0;p<0.05),平均Lysholm得分(53.9vs.92.2;p<0.05),平均Tegner活动得分(3.2与8.3;p<0.05)和平均ROM(42.9°vs133.1°;p<0.05)。
结论:关节镜下复位改良缝合桥固定治疗ACL胫骨止点撕脱骨折是一种可靠的、值得推荐的治疗方法,能有效恢复膝关节的稳定性和功能,值得临床推广。