关节镜下钢丝和空心钉固定治疗胫骨髁间前棘骨折的疗效比较  

Arthroscopic treatment of anterior tibial spine fractures with Kirschner wire and cannulated screw

作　　者：周亮[1] 徐斌[1] 王英明[1] 钱三祥[1] 

机构地区：[1]安徽医科大学第一附属医院骨四科,安徽合肥230022

出　　处：《中国内镜杂志》2011年第8期809-812,共4页China Journal of Endoscopy

摘　　要：目的探讨关节镜下钢丝捆扎固定与空心钉固定治疗胫骨髁间前棘骨折的疗效。方法关节镜下采用2种固定方法治疗胫骨髁间前棘骨折患者40例:钢丝捆扎固定20例(A组),空心钉固定20例(B组)。在关节镜监视下,对移位或粉碎骨折块进行复位,用钢丝或空心钉对骨折块行内固定,同时处理合并伤。膝关节功能采用Lysholm评分标准评定:术前为42.5分(35～46)分。术后使用支具于伸膝位制动4～6周,术后给予相应阶段的康复指导。结果 40例患者术后均获得随访,平均18个月(6～36个月),X线片示骨折复位满意,愈合良好。术后末次随访膝关节Lysholm评分为95.5(89～100)分,手术前、后比较差异有显著性(P<0.05),其中优32例,良5例,差3例,优良率92.5%。术后出现2例膝关节不稳,1例屈曲受限。结论关节镜下钢丝捆扎固定与空心钉固定治疗胫骨髁间前棘骨折均具有创伤小、内固定可靠等优势,疗效满意。[Objective] To study the curative effects of arthroscopic treatment of anterior tibial spine fractures with Kirschner wire and cannulated screw.[Methods] Arthroscopic treatment of two kinds of fixation of anterior tibial intercondylar eminence fractures was 40 cases,which included Kirschner wire fixed（Group A,n =20） and cannulated screw fixed（Group B,n =20）.The fracture was reduced and fixed with the Kirschner wires or cannulated screws.The associated injury was treated at the same time.With an average Lysholm knee score of pre operation 42.5（35~46）.The injured leg was fixed by brace on knee-extended position for 4~6 weeks after operation.Rehabilitation instructions were performed according to different stages.[Results] All the patients were followed up for an average of 18（6~36） months.X ray revealed satisfactory reduction and union of the fractures.With an average Lysholm knee score of postoperation of 95.5（89~100）.The difference between preoperation and postoperation was statistically significant（P 0.05）,32 cases were excellent,5 cases were good,3 cases were unfair.[Conclusion] Arthroscopic reduction and internal fixation is effective for treatment of anterior tibial spine fractures with the Kirschner wires and cannulated screw,due to its less trauma and reliable fixation.The results were satisfactory.

关 键 词：胫骨髁间前棘 骨折 关节镜 

分 类 号：R684[医药卫生—骨科学]