ABSTRACT
Objective@#To compare the clinical results between arthroscopic anchor suture bridge and Ethibond suture bone tunnel for anterior cruciate ligament (ACL) tibial avulsion fractures.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 18 patients with ACL tibial avulsion fracture admitted to Wenzhou Central Hospital from June 2012 to June 2017. There were 14 males and four females, aged 12-57 years, with an average age of 31.4 years. According to the Meyers-McKeever classification, there were six patients with type II and 12 patients with type III. Seven patients underwent anchor suture bridge fixation (anchor group), and 11 patients underwent Ethibond suture bone tunnel fixation (Ethibond suture group). The operation time, range of motion (ROM) of knee joint, Lysholm knee score and International Knee Documentation Committee (IKDC) knee score of the two groups were compared before operation and 3, 6 and 12 months after operation.@*Results@#All patients were followed up for 12-36 months, with an average of 20.18 months. The operation time of anchor group [(87.14±8.59)minutes]was longer than that of Ethibond suture group [(71.1±11.5)minutes](P<0.05). The ROM of anchor group and Ethibond suture group was (127.1±8.6)° and (124.1±7.4)° respectively at 3 months after surgery, showing no statistical difference between the two groups (P>0.05). But the functional knee scores (Lysholm score and the IKDC score) revealed better clinical results in anchor group [(91.9±3.0)points, (85.6±4.1) points respectively] than Ethibond suture group [(88.6±3.3)points, (79.9±4.9)points respectively] at 3 months after surgery (P<0.05). There were significant differences between before and after operation within two groups regarding the knee function scores including ROM, Lysholm knee score and IKDC score (P<0.05). Three months after operation, there were significant differences between the two groups in terms of the Lysholm score and IKDC score (P<0.05), but there were no statistical differences between two groups at 6 months and 12 months after surgery (P>0.05).@*Conclusions@#Both arthroscopic anchor and Ethibond suture can achieve plane fixation of fracture, but there is no significant difference in the long-term effect of improving knee joint mobility and restoring knee joint function between the two approaches. However, the anchor group can achieve early recovery of knee joint function.
ABSTRACT
Objective To compare the clinical results between arthroscopic anchor suture bridge and Ethibond suture bone tunnel for anterior cruciate ligament (ACL) tibial avulsion fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 18 patients with ACL tibial avulsion fracture admitted to Wenzhou Central Hospital from June 2012 to June 2017.There were 14 males and four females,aged 12-57 years,with an average age of 31.4 years.According to the Meyers-McKeever classification,there were six patients with type Ⅱ and 12 patients with type Ⅲ.Seven patients underwent anchor suture bridge fixation (anchor group),and 11 patients underwent Ethibond suture bone tunnel fixation (Ethibond suture group).The operation time,range of motion (ROM) of knee joint,Lysholm knee score and International Knee Documentation Committee (IKDC)knee score of the two groups were compared before operation and 3,6 and 12 months after operation.Results All patients were followed up for 12-36 months,with an average of 20.18 months.The operation time of anchor group [(87.14 ±8.59)minutes] was longer than that of Ethibond suture group [(71.1 ± 11.5)minutes] (P ＜ 0.05).The ROM of anchor group and Ethibond suture group was (127.1 ±8.6)° and (124.1 ±7.4)° respectively at 3 months after surgery,showing no statistical difference between the two groups (P ＞ 0.05).But the functional knee scores (Lysholm score and the IKDC score) revealed better clinical results in anchor group [(9 1.9 ± 3.0) points,(85.6 ± 4.1) points respectively] than Ethibond suture group [(88.6 ± 3.3) points,(79.9 ± 4.9) points respectively] at 3 months after surgery (P ＜ O.05).There were significant differences between before and after operation within two groups regarding the knee function scores including ROM,Lysholm knee score and IKDC score (P ＜ 0.05).Three months after operation,there were significant differences between the two groups in terms of the Lysholm score and IKDC score (P ＜ 0.05),but there were no statistical differences between two groups at 6 months and 12 months after surgery (P ＞ 0.05).Conclusions Both arthroscopic anchor and Ethibond suture can achieve plane fixation of fracture,but there is no significant difference in the long-term effect of improving knee joint mobility and restoring knee joint function between the two approaches.However,the anchor group can achieve early recovery of knee joint function.
ABSTRACT
ObjectiveTo investigate the radiological characteristics,morphological characteristics of fracture fragments and treatments of posterior bicondylar tibial plateau fractures.MethodsA total of 47 patients with posterior bicondylar tibial plateau fractures treated between March 2005 and February 2009 were enrolled in the study.Characteristics of fractures and morphologies of fracture fragments were measured precisely with CT-chip Starpacs system.A retrospective study was carried out on the therapeutic results of the 47 patients undergone lateral condylar plate and medial condylar lag screw fixation via anterolateral combined with anteromedial tibial plateau approaches.Results Posteromedial condylar fracture was split one with small displacement,but the fracture was unstable.In the meantime,the fracture fragments were inverted three prism in shape and remained quite intact.Posterolateral condylar fracture was compression one and was often associated with soft tissue injury of knee joints.According to the Rasmussen radiology score,the results were excellent in 24 patients,good in 18,fair in three and poor in two.According to the Rasmussen function score,the results were excellent in 13 patients,good in 27,fair in two and poor in five.ConclusionsThe morphous of posteromedial condylar fracture is similar with that of Hohl type E fracture.The posterolateral condylar fracture is compression one.Anterolateral combined with anteromedial approaches for posterior tibial plateau fractures allow stage Ⅰbone fusion with internal fixation,simultaneously repair recombined injuries and achieve excellent radiological and clinical results.