关节镜下治疗陈旧性胫骨髁间棘撕脱骨折  

Arthroscopic Treatment of Old Avulsion Fracture of the Tibial Intercondylar Eminence

作　　者：严力军[1] 王邦军[1] 梅荣成[1] 廉凯[1] 

机构地区：[1]湖北省襄樊市中心医院骨科,湖北襄樊441021

出　　处：《实用骨科杂志》2010年第6期417-419,共3页Journal of Practical Orthopaedics

摘　　要：目的介绍陈旧性胫骨髁间棘撕脱骨折在关节镜下复位、空心钉固定的治疗方法。方法自2004年1月至2007年12月,采用关节镜下复位、空心钉固定治疗32例陈旧性胫骨髁间棘撕脱骨折。男20例,女12例;平均年龄31.5岁（18-55岁）。依据Meyers和Zaricznyj分型标准,型9例（28.1%）,型20例（62.5%）,型3例（9.4%）。结果术后3个月所有病例骨折均愈合,平均随访时间18.5个月（6-24个月）。Lachman试验均为阴性;Lysholm评分为91-100分,平均（95.6±2.3）分,和术前（71.5±4.8）分比较差异有统计学意义（P〈0.01）。关节活动度正常者30例,屈膝活动受限者2例,但均小于10°。6例患者存留轻度膝前疼痛。结论关节镜下空心钉固定治疗陈旧性胫骨髁间棘撕脱骨折能达到骨折愈合、重建关节稳定性、恢复关节运动功能的目的 。Objective To describe the arthroscopic reductions and fixation of old tibial intercondylar eminence fracture with cannulated screw.Methods During January 2004 to December 2007,32 patients were treated arthroscopically for fracture of the tibial intercondylar eminence.There were 20 male and 12 female,with age of 18～55 years（mean 31.5 years）.Among the 32 patients,there were 9 type Ⅱ fractures（28.1%）,20 type Ⅲ fractures（62.5%） and 3 type Ⅳ fractures（9.4%）.Results Average follow-up was 18.5 months（range from 6 to 24 months）.Fractures were united within 3 months after operation in all cases.Lachman test were negative in all patients postoperatively.The Lysholm score was 91 to 100,with an average of（95.6±2.3）,and significantly increased compared to（71.5±4.8）before operation（P〈0.01）.The range of motion was normal in 30 patients.Flexion deficit was found in 2 cases,but within 100.Mild anterior knee pains were found in 6 patients.Conclusion Arthroscopic treatment of old avulsion fracture of the tibial intercondylar eminence with cannulated screw fixation technique can ensure fracture healing,restore the stability and recover the function of the joint in most patients.

关 键 词：陈旧性 胫骨骨折 关节镜检查 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学]