ABSTRACT
Objective To investigate the clinical outcomes of arthroscopic fixation with double-EndoButton for avulsion fracture of anterior cruciate ligament. Methods In the period from January 2016 to April 2017,a total of 12 patients with avulsion fracture of anterior cruciate ligament received arthroscopic fixation with double -EndoButton technique.Range of motion exercises were allowed from 2 to 4 weeks postoperatively,partial weight bearing walking with brace was allowed from 4 weeks postoperatively,and full weight bearing walking was gradually started from 8 to 12 weeks postoperatively.The X-ray was used for evaluation of fracture reduction and bone union.The knee stability was checked by anterior drawer test, the Lachman test and the pivot-shift test.The knee joint function was accessed by the Lysholm Knee Score system. Results The mean operation time was 55-115 min(mean,79.5 min) and the postoperative length of stay was 4 -7 d(mean, 4.8 d).The 12 patients were followed up for 3 -12 months(mean, 7.8 months).All the patients achieved anatomic reduction and bone union at final follow -up.The results of postoperative anterior drawer test, Lachman test and pivot-shift test were negative.The Lysholm knee score was improved from(44.5 ±2.1)points preoperatively to(92.3 ±1.9)points at final follow-up, with statistically significant difference(t =69.983, P =0.000). Conclusions Arthroscopic fixation with double-EndoButton technique is effective for the treatment of avulsion fracture of anterior cruciate ligament.It is convenient for fracture reduction and fixation,providing sufficient stability for early functional rehabilitation of knee joint postoperatively.
ABSTRACT
Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1) acted as controls.The incidence of SD and Scheuermann's signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann's signs was compared to that within segments without Scheuermann's signs.Results All except one patient in TLDH group(97.8%) had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann's signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann's signs was all higher than that within segments without Scheuermann's signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl's node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.