经膝关节镜微创内固定治疗青少年股骨髁骨软骨骨折的临床疗效  

The clinical study of minimally invasive internal fixation with knee arthroscopy in the treatment of femoral condylar osteochondral fracture in adolescents

作　　者：王国胜[1] 高健[1] 尕蓉莉[1] 续斌[1] 曹明宇[1] 徐昌[1] 艾尔西丁.阿不来提 马强[1] 沈志敏[1] WANG Guosheng GAO Jian GA Rongli XU Bin CAO Mingyu XU Chang Aierxiding MA Qiang SHEN Zhimin(Department of Joint Surgery, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Chin)

机构地区：[1]新疆医科大学第六附属医院关节外科,乌鲁木齐830002

出　　处：《新疆医科大学学报》2016年第11期1412-1415,共4页Journal of Xinjiang Medical University

基　　金：新疆医科大学科研创新基金(XYDCX2014179)

摘　　要：目的探究膝关节镜引导下微创小切口复位使用掌指骨螺钉内固定治疗青少年股骨髁骨软骨骨折的临床疗效。方法选择2014年1月-2015年10月新疆医科大学第六附属医院关节外科收治的青少年股骨髁骨软骨骨折的患者103例,分析接受关节镜引导下微创小切口复位掌指骨螺钉内固定治疗的临床疗效,其中男性48例,女性55例,年龄10~17岁（平均14.7岁）,内侧髁30例,外侧髁73例。术前Lysholm评分（41.90±4.94）分,IKDC评分（32.20±4.01）分。比较手术前、后影像学变化,且分别于术后3、6个月进行随访,末次随访时采用Lysholm评分和IKDC评分评估术后患者膝关节功能恢复情况。结果术后3个月,Lysholm评分为（82.90±1.87）分,术后较术前评分显著提高,差异有统计学意义（t=-42.58,P〈0.001）;IKDC评分为（66.50±3.17）分,术后较术前评分显著提高,差异有统计学意义（t=-36.7,P〈0.001）。结论膝关节镜引导下微创小切口复位后使用掌指骨螺钉内固定是治疗股骨髁骨软骨骨折的有效方法,其具有创伤小、术后功能恢复快的优点,值得在临床上推广。Objective To explore the clinical efficacy of minimally invasive incision under arthroscopy using metacarpal bone screw to treat adolescent osteochondral fracture of the femoral condyle. Methods The data of 103 cases with osteochondral fracture of the femoral condyle received minimally invasive incision under arthroscopy using metacarpal bone screw in the Sixth Affiliated Hospital of Xinjiang Medical University from January 2014 to October2015 were analyzed. There were 48 males and 55 females aged from 10 to 17 years old（ mean 14. 7 years）,and there were 30 internal condyle patients and 73 external condyle patients. The preoperative Lysholm score was（ 41.90 ± 4. 94）,and the preoperative IKDC score was（ 32. 20 ± 4. 01）. The imaging changes before and after operation were compared. Lysholm score and IKDC score at 3,6 months after operation and final follow- up were used to evaluate the recovery of knee function. Results At 3 months after operation,Lysholm score was（ 82. 90 ± 1.87）,The postoperative scores improved compared to preoperative scores,the difference is statistically significant（ t=- 42. 58,P 〈0. 001）; IKDC score was（ 66. 50 ± 3. 17）,The postoperative scores improved compared to preoperative scores,the difference is statistically significant（ t =- 42. 58,P〈 0. 001）. Conclusion Minimally invasive incision under arthroscopy use metacarpal bone screw was an effective operative method for adolescent osteochondral fracture of the femoral condyle. The advantages of small trauma and quicker recovery of knee＇s function are worth popularizing in clinic.

关 键 词：股骨髁 骨软骨骨折 经膝关节镜 骨折固定术 内固定 

分 类 号：R683[医药卫生—骨科学]