关节镜辅助下治疗前叉韧带胫骨髁间棘撕脱性骨折的临床疗效  

Clinical efficacy analysis on arthroscopic treatment of tibial intercondylar eminence avulsion fracture

作　　者：刘阳[1] 孙学斌[1] 李纲[1] 张克远[1] 尼加提.阿不力米提 

机构地区：[1]新疆医科大学第一附属医院骨肿瘤与运动损伤科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2014年第1期89-92,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A077)

摘　　要：目的探讨关节镜辅助下治疗前叉韧带胫骨髁间棘撕脱性骨折的疗效。方法选择2008年6月一2012年12月行关节镜下前叉韧带胫骨髁间棘撕脱性骨折患者115例。关节镜监视下行骨折清创复位，利用前十字韧带胫骨导向器在骨折床上精确定位钻成对的2mm骨隧道，双股骨科高强缝线关节内“十”字形固定骨块，缝线的末端拴桩固定于关节外螺钉上。比较术前、术后Lysholm评分及膝关节活动度情况。结果完成随访97例，随访时间6～54个月，平均28．7个月。末次随访时拍x线片示骨折均解剖复位或接近解剖复位；Lachman试验均为阴性；术后Lysholm评分为（94．2±3．6）分，与术前（46．5±2．9）分比较，差异有统计学意义（P〈0．05）。术后膝关节活动度正常者88例；术后4～6w出现膝关节屈曲轻度受限者8例，活动度0°～90°，给予闭合松解后膝关节活动度恢复至0°～120°；发生严重膝关节纤维化者1例，活动度0°～30°，再次行关节镜下松解后膝关节活动度达0°～100°。结论关节镜手术治疗前交叉韧带胫骨髁间棘撕脱性骨折创伤小，方法可靠、易行，可作为治疗此类骨折的常规方法。Objective To investigate the clinieal effects of arthroscopic treatment of avulsion fractures of tibial intercondylar eminence. Methods Conducting 115 arthroscopic treatments for patients with avulsion fractures of tibia1 interconclylar eminence from June 2008 to December 2012. Using arthroseopy to observe debridement and reset of downward fracture, using anterior eruciate ligament tibial guide to drilled a pair of 2mm tunnel on the fracture bed, and using double-stranded high-strength suture to fix the orthopedic joint with ＂十＂ shaped fixation （the end of the suture tied on extra-articular screw fixation）. Comparing Lysholm score and the mobility of knee-joint before and after operation. Results Ninety-seven patients were followed up for 6 to 54 months with average of 28.7 months. The clinical results were proved to be satisfactory radiographicatly. They have （94.2±3.6） Lysholm＇s scores compared with （46.5±2.9） in the pre-operational period, and Lachman test were negative. Eighty-eight knees have normal mobility, and eight knees had slightly limited range of motion within 4 to 6 weeks after operation, with mobility being 0° - 90°and 0°- 120°after receiving closed to ease treatment. There was one knee fibration, which experienced arthroscope release again after, and its mobility was restored to 0°-100°from 0°-30°. Conclusion The arthroscopic fixation technique is less invasive and stable for the reduction and fixation of tibial eminence fracture. Knee function can be reserved and early mobilization can benefit from the technique.

关 键 词：关节镜 胫骨髁间棘骨折 固定 

分 类 号：R683.4[医药卫生—骨科学]