Objective To investigate the clinical effect of arthroscopic fixation with TwinFix anchors and double Ethibond sutures on tibial eminence avulsion fracture.Methods Data of 14 patients who have tibial eminence avulsion fracture of Meyer-Mckeever Ⅲ type from January 2016 to December 2017 in our department were analyzed,including 8 cases of maleand 6 cases of female.They were 18~54 years old (mean 37.4±9.12).There were 9 cases of left knee and 5 cases of right knee.There were 11 cases of type ⅢA and 3 cases of type ⅢB.And there were fresh fracture in 12 cases,dated fracture in 2 cases.All patients accepted arthroscopic reduction and suture anchor fixation through double bone tunnels,and had evaluated by lysholm knee score after operation.Results The mean operation time was (48.0± 5.52)mins (range,40~60mins).All the patients were followed up.The mean follow-up period was (14.8±4.31)months(range,6~24 months).All the fractures healed after 3 months of follow-up.The patients were followed up to 6 months,the Lysholm score was (94.8±3.4)(range,70~98).The 5 patients were followed up to 24 months,and the Lysholm score was (95.6±2.9).All 14 patients were negative for Lanchman test.In 13 patients,the range of motion of knee joint was normal,and only 1 patient (repaired medial collateral ligament at the same time) extended and returned to normal,with a flexion of 90°~100°.Conclusion The method of treatment of tibial eminence avulsion fracture with TwinFix suture anchors has following advantages:small in wounding,simple in operation,reliable in fixation,good in knee stability,few in complication,and has excellent clinical effect which is worthy of promotion.
[1]Sang W,Zhu L,Ma J,et al.A comparative study of two methods for treating type Ⅲ tibial eminence avulsion fracture in adults[J].Knee Surg Sports Traumatol Arthrosc,2012,20(8):1560-1564.
[2]张志伟,李忠.前交叉韧带胫骨止点撕脱骨折的治疗进展[J].西南军医,2016,18(5):457-460.
[3]Estes AR,Oladeji LO.Arthroscopic treatment of tibial spine malunion with resorbable screws[J].Am J Orthop(Belle Mead NJ),2015,44(5):E160-E164.
[4]Meyers MH,Mckeever FM.Fracture of the intercondylar eminence of the tibia [J].J Bone Joint Surg(Am),1970,52(8):1677-1684.
[5]Lubowitz JH,Elson WS,Guttmann D.Part Ⅱ:Fracture of the intercondylar eminence of the tibia[J].Arthroscopy,2005,21(1):86-92.
[6]孙鲁宁,沈计荣,杜斌.关节镜下缝线固定治疗胫骨髁问隆突骨折[J].中国骨与关节损伤杂志,2008,23(7):583-584.
[7]蒋逸秋,桂鉴超,王黎明,等.关节镜下单隧道改良缝线法治疗胫骨髁间嵴撕脱骨折[J].南京医科大学学报(自然科学版),2010,30(5):721-724.
[8]Brunner S,Vavken P,Kilger R,et al.Absorbable and non-absorbable suture fixation results in similar out-comes for tibial eminence fractures in children and ado-lescents[J].Knee Surg Sports Traumatol Arthrosc,2016,24(3):723-729.
[9]Zhao QC,Deng XW,Zhou P,et al.Arthroscopic treat-ment of tibialintercondylar eminence fractures in children with single Kirschner wire and suture avoiding epiphyseal line fixation technique[J].Zhongguo Gushang,2015,28(6):504-507.
[10]Yang SW,Lu YC,Teng HP,et al.Arthroscopic reduction and suture fixation of displaced tibial intercondylar eminence fractures in adults [J].Arch Orthop Trauma Surg,2005,125(4):272-276.
[11]陈双涛,张翼飞,孔涛涛,等.关节镜下双“8”字缝线固定治疗青少年前交叉韧带胫骨止点撕脱骨折[J].实用骨科杂志,2019,25(5):463-465.
[12]杨永鹏.关节镜下空心螺钉与缝线固定治疗胫骨髁间嵴骨折临床效果比较的Meta分析[D].江西:南昌大学,2018:10-13.
[13]赵金忠,皇甫小桥.关节镜下锚钉缝线固定治疗前十字韧带撕脱骨折不愈合[J].中华骨科杂志,2007,27(3):188.