关节镜下治疗前叉止点撕脱性骨折

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1、AvulsionFractureofAnteriorCruciateLigamentZhijieXiHistory1875——Poncet1970——AvulsionfractureoftheACLwasclassifiedbyMeyersMH1996——VeselkoMperformedarthroscopicplacementandremovalofcannulatedscrewforfixation2008——JinzhongZhaoreportedarthroscopicFigure-of-8sut

2、urefixationtechniqueMorbidity——3/10000014％ofACLinjuryDistributionofagechildren——8～14yearsoldoldwomen——over40yearsoldAccidE-mergNurs，2004，12(3)：173-175．InternationalJournalofPediatrics,2012,ArticleID932702,6pagesepidemiologyFallinjuryandtrafficaccident——51％

3、Sportsinjuries——Skiingandfootball--14%TheKnee，2008，15(3)：164-167．Associatedwithcapsuletearofmeniscusorarticularcapsule,sometimesincludingmedialandlateralcollateralligamentinjuryorinjuryofarticularcartilageArthroscopy:TheJournalofArthroscopicandRelatedSurge

4、ry,2005,21(1):86-92.RelevantanatomicalstructureResidentridgeResidentridgeBranchingridgeFootprintsFootprintsTheanteriormedialbundleistightinflexiontheposteriorlateralbundleistightinthestraightposition12损伤机制Youngpeople-kneeflexion,tibialinternalrotationAdul

5、ts-hyperextensionofthekneeACLlimitsanteriordisplacement,hyperextension,andinternalrotationDiagnosisInjuryhistoryofhyperextensionofkneeBruiseandhyphemaTheextensionwaslimitedAnteriordrawertestandLachmansignarepositiveX-rayandCTareconducivetounderstandingoffr

6、actureMRIishelpfultounderstandinjuryofACL,andotherscombinedinjury.AnteriordrawertestandLachmansignX-rayCTMRIMeyers-McKeeverclassificationArthroscopy2005;21[1]:86-92HowtoidentifyfreshoroldfracturesinimagingTreatmentItype---Conservativetreatmenttokeeptheknee

7、inafunctionalpositionfor6weeksⅡandⅢtypes---Manipulation，iffail，selectedsurgeryⅣtype---SurgeryReductionThedrawertestafterextensionP-R-I-C–EprogramProtectionRestIceCompressionElevateItusedtobethemostcommonlytreatmentprogramtoopenreductionandfixedwithwireAfai

8、ledcaseCase1SingletunnelfixationwithsteelwireandextrusionscrewNoextrusionnailwasfoundbeforeoperationimpingeIfthefracturemassissmall,usingEthibondsutureOldfractureofavulsionfractureofACLCase2WoundfreshnessTocl