Curative Effect Observation Of Arthroscopic High-strength Wire Fixation With Neckwear Kont For Anterior Cruciate Ligament Tibialavlsion Fractures In Children

Objective To investigate the effects of arthroscopic high-strength wire fixation with neckwear knot for anterior cruciate ligament(ACL)tibial avulsion fractures in children.Methods From Apr.2014 to Mar.2016,19 children patients with tibial avulsion fractures of ACL were treated with high-strength wire with neckwear knot under arthroscope.They were 11 girls,8boys,aged5~14(average,11.6years).According to Meyers-McKeever-Zaricznyj ssification,10 cases were type II,6 cases were type III and 3 were type IV.Follow-up X-ray and CT examinations were carried out to evaluate the bone union.Anterior drawer test,Lachman test,knee range of motion,Lysholm and international knee documentation committee(IKDC)score were conducted at all clinical follow-up visits to evaluate functional recovery of knee joint.Results 19 patients were followed-up range from 6 to 24 months with an average 12.8months.All fractures were united at 3 months after operation.The knee flextion and extension range of motion(ROM)was normal in all patients at 6 months after operation.The Lysholm scores were improved from 49.16±7.31 preoperatively to 92.21±3.58(t=26.1,P<0.01)and the IKDC scores were increased from 45.42±5.45 preoperatively to 90.95±3.08(t=45.2,P<0.01)at 6months after operation.The anterior drawer test and Lachman test were all negative.There was no significant difference in the length of the double leg and no abnormality of epiphyseal growth plate was found.Conclusion Arthroscopic high-strength wire fixation with neckwear knot for ACL tibial avulsion fractures is an effective means with the advantages of minimal trauma,reliable fixation,good functional recovery and less epiphyseal injury.