关节镜下儿童胫骨髁间棘骨折复位缝合加软骨钉固定的疗效观察  

Curative effect observation of therapy of reduction suture and cartilage nailing under arthroscopy for intercondylar spine of tibia fracture

作　　者：杨威[1] 李祁伟[1] 

机构地区：[1]中国医科大学附属盛京医院,沈阳110004

出　　处：《中国当代医药》2013年第27期172-173,共2页China Modern Medicine

摘　　要：目的探讨关节镜下儿童胫骨髁间棘骨折复位缝合加软骨钉固定的临床疗效。方法对2009年1月1日～2012年6月30日本院收治的8例儿童胫骨髁间棘骨折的临床资料进行分析,所有患者进行关节镜探查、关节腔清理、骨折复位、撕脱骨块缝合加软骨钉固定,治疗后随访6～42个月,按照Lysholm评分方法了解骨折愈合、关节屈伸、膝关节负重后稳定性等情况。结果所有患者切口Ⅰ期愈合,平均随访22个月。骨折愈合时间为4～8周,平均5周,1例复查X线片可见胫骨髁间棘仍有分离,但膝关节屈伸无影响,无髁间窝撞击表现,其余7例均骨折愈合良好,膝关节屈伸活动良好。Lysholm评分优秀7例,良好1例,一般及差0例。同时6个月内随着时间的延长关节功能持续恢复。结论儿童胫骨髁间棘骨折以Ⅱ、Ⅲ型多见,单纯骨折为主,很少合并半月板损伤。关节镜下缝合加软骨钉固定法操作简便、手术创伤小、恢复快,符合儿童骨生长快的特点。Objective To explore the curative effect of therapy of reduction suture and carhlage nailing unuer arthroscopy in treatment of tibial spine fractures according to pediatric tibial spine growth characteristics and fracture classifications.Methods The clinical data of 8 cases of pediatric patients with tibial spine fractures in our hospital from January 1,2009 to June 30,2012 were analyzed.The arthroscopic exploration,joint cavity cleaning,fracture reduction, avulsed bone suture plus cartilage nailing were given to all the patients.The following up lasted for 6 to 42 months, fracture healing,joint flexion,the stability of the posterolateral load-posion of the knee were evaluated according to Lysholm scores.Results All patients healed by first intention,with an average following up of 22 months.The average healing time was 5 weeks （4-8 weeks）;1 case showed partially separated tibial spine in X-ray reexamination,but had normal knee flexion and no intercondylar notch impingement;the remaining 7 cases had good fracture healings as well as good range of knee motion.For Lysholm scores of all patients,7 cases were excellent,1 case was good and none was fair or poor.And within postoperative 6 months,the joint functions of all patients had sustained recoveries over time. Conclusion The Type II, III are commonly seen in pediatric tibial spine fractures,in which the simple fractures are frequently occurred rather than combined meniscus injuries.The therapy of reduction suture and cartilage nailing under arthroscopy for tibial spine fractures is easy to operate and less invasive,and has less recovery time,it is suitable for the pediatric patients owing to the latter＇s rapid bone growths.

关 键 词：胫骨髁间棘骨折 儿童 关节镜 外科手术 软骨钉 

分 类 号：R683.42[医药卫生—骨科学]