关节镜辅助下胫骨髁间棘撕脱性骨折的手术治疗  

作　　者：于情[1] 朱礼贤[1] 

机构地区：[1]江苏省泰州市人民医院骨科,225300

出　　处：《中国现代药物应用》2009年第15期53-54,共2页Chinese Journal of Modern Drug Application

摘　　要：目的探讨在关节镜辅助下对胫骨髁间棘撕脱性骨折进行微创治疗的手术方法及近期疗效。方法自2005年10月-2008年1月,共手术治疗9例胫骨髁间棘骨折,合并半月板损伤2例。术中在关节镜辅助下,首先对合并损伤进行相应处理,然后依靠器械对骨折进行解剖复位,通过克氏针暂时固定,C形臂X线机透视确认后,再选择松质骨螺钉或钢丝固定,最后再次透视检查。术后按程序进行康复锻炼。结果本组髁间棘撕脱性骨折均发生在前交叉韧带止点处。2例采用钢丝固定外,其余均采用钛质空心加压拉力螺钉固定。全部患者均获随访,平均时间15±2个月,骨折在3～4个月骨性愈合,术后无切口愈合不良、感染和骨筋膜室综合征等早期并发症,6例膝关节功能完全正常,3例活动范围0°～100°。结论在治疗胫骨髁间棘撕脱性骨折时,采用关节镜辅助下的有限切口结合少量固定的手术,具有创伤小、可同时处理关节腔内的其他损伤等优势,可以获得骨折愈合快、膝关节功能良好的近期疗效,值得推广应用。Objective To investigate the under-assisted arthroscopic tibial spine avulsion fracture of minimally invasive surgical methods of treatment and short-term effect. Methods From October 2005 -2008 In January, a total of nine cases of surgical treatment of tibial spine fractures, two cases of meniscus injury combined.Intraoperative arthroscopic assisted in, the first corresponding to the merger deal with injury, and then rely on the equipment for anatomic reduction of fracture by temporary Kirschner wire fixation, C-arm X- ray machine Perspective confirmation, and then select the cancellous bone screw or wire fixed, and finally refluoroscopy. Rehabilitation after exercise in accordance with the procedure. Results The inter-condylar fracture of spine avulsion occurred only in the former point cruciate ligament. Two cases of the use of fixed wire, the rest are hollow titanium compression lag screw fixation.All patients were followed up, the average time 15 ± 2 months, the fracture in the 3 - 4 months of healing bone, wound healing after non-poor and bone infections, such as compartment syndrome of early complications, six cases of knee joint function entirely normal, three eases of the scope of activities of 0 ° - 100 °. Conclusion in the treatment of tibial spine avulsion fracture, the use of arthroscopy-assisted limited incision a small amount of a fixed combination of surgery, with less trauma and at the same time dealing with intra-articular injuries of the other advantages of fracture healing can be faster, good knee function of short-term effect, it is applied.

关 键 词：胫骨髁骨折 关节镜 

分 类 号：R687.3[医药卫生—骨科学]