关节镜下缝线固定治疗儿童胫骨髁间前棘骨折  

Arthroscopic Treatment of Anterior Tibial Intercondylar Eminence Fracture with Suture Fixation in Children

作　　者：仲肇平[1] 狄正林[1] 徐荣明[1] 彭琳瑞[1] 陈秋[1] 曹进[1] 

机构地区：[1]浙江省宁波市第六医院小儿骨科,315000

出　　处：《中国骨与关节损伤杂志》2008年第8期643-645,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨关节镜下应用缝线固定治疗儿童胫骨髁间前棘骨折的临床疗效。方法2003年5月～2006年7月,对11例胫骨髁间前棘骨折移位患儿,在关节镜下行骨折复位。以钢丝引导PDSⅡ缝线经骨隧道固定,术后石膏或支具外固定。术后随访采用IKDC和Lysholm评分标准评估疗效。结果全部病例均获随访,平均随访14个月(6～28个月),膝关节活动均正常,Lachman试验阴性;3～6个月,患儿均已恢复正常生活及部分体育锻炼;X线片显示骨折愈合。术后末次随访,KT-2000检查双膝松弛度相差0～4mm(平均1.5mm)。Lysholm评分术后末次随访93～100分,与术前56～79分比较,差异有统计学意义(P<0.01)。术后IKDC评分分级为A级(8例,占72.72%)和B级(3例,占27.28%)。结论儿童胫骨髁间前棘骨折经关节镜下骨折复位、缝线固定是一种创伤小、不损伤骺板、疗效可靠的治疗方法。Objective To explore the effect of arthroscopic reduction and internal fixation with suture in treatment of anterior tibial intercondylar eminence fracture in children. Methods From May 2003 to July 2006, 11 patients with anterior tibial intercondylar eminence fracture were operated （arthroscopic reduction and internal fixation with suture）. A tunnel was drilled from the anterior surface of tibial metaphysis to the articular cavity and the fracture was fixed with the suture through the tunnel and external fixation with plaster after operation. IKDC and Lysholm system were used in the follow up. Results All patients were followed - up for 6-28 months （average 14 months） and achieved normal range of movement. Lachman test was negative in all patients postoperatively. Three to 6 months later, all children could live normally and exercised partly, and the radiography showed that all fractures were healed. At the last follow up, KT-2000 manual displacement was 0--4 mm （average 1.5 mm）. Lysholm score was 93--100 points postoperatively and the grade were A （8 patients, 72.72 %） and B （3 patients, 27.28% ） according to IKDC system. In the mean time, the score was 56--79 points preoperatively. The result had statistical significance （P 〈 0.01 ）. Conclusion Arthroscopic operation is excellent in the treatment of anterior tibial intercondylar eminence fracture in children.

关 键 词：儿童 胫骨 骨折 关节镜 检查 

分 类 号：R683.42[医药卫生—骨科学] R687.4[医药卫生—外科学]