关节镜下线型固定青少年胫骨髁间隆起撕脱骨折的临床疗效评价  

Clinical effectiveness of fixing teenagers' avulsion fracture of tibial intercondylar eminence with wires under arthroscopy

作　　者：黄浩然[1] 刘玉新[2] 滕学仁[2] 戴世友[2] 

机构地区：[1]泰山医学院,山东泰安271000 [2]青岛市市立医院

出　　处：《中国骨与关节损伤杂志》2017年第4期368-371,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价关节镜下线型固定青少年胫骨髁间隆起撕脱骨折的临床疗效。方法笔者选择自2014-09—2015-09初次关节镜下线型固定18例青少年胫骨髁间隆起撕脱骨折,观察其术后疗效。术后应用症状与体征量化评分标准、Lysholm评分评估其术后疗效。结果术后切口均一期愈合。术后18例获得随访平均6(3~9)个月。症状与体征量化评分标准评分结果:优14例,良2例,可1例,差1例,优良率88.9%。术后立即复查X线片示骨折断端复位良好,术后3个月再次复查均达到骨性愈合,未见创伤性关节炎表现。17例前抽屉试验(-)、Lachman试验(-),1例前抽屉试验(+-)、Lachman试验(-)。末次随访Lysholm评分为(93.8±3.7)分,与术前(45.2±6.4)分比较,差异有统计学意义(t=27.892,P<0.001);末次随访IKDC2000主观膝关节评分平均为(90.2±4.2)分,与术前(49.8±5.1)分比较,差异有统计学意义(t=25.943,P<0.001)。术后肢体功能恢复满意。结论对于青少年胫骨髁间隆起撕脱骨折的治疗,关节镜下线型内固定不仅能够有效复位骨折断端,而且固定效果确切,有利于早期膝关节功能的恢复,能够在短时间内最大程度恢复膝关节的稳定性。Objective To evaluate clinical effectiveness of fixing teenagers＂ avulsion fracture of tibial intercondylar eminence with wires under arthroscopy. Methods Eighteen teenagers with avulsion fracture of tibial intercondylar eminence who were treated in the department where the author worked from September 2014 to September 2015 by wire fixation under arthroscopy for the first time were examined to observe their postoperative outcomes. The postoperative outcomes were evaluated based on their postoperative symptoms, quantified sign scoring standards and Lyscholm scores. Results All wounds were healed by first intention after operations. After operations, 18 cases were followed up for 6 months （3-9） on average. According to the symptoms and scores obtained based on quantified sign scoring standards, there were 14 cases with excellent outcomes, 2 eases with good outcomes, 1 case with acceptable outcomes and 1 case with poor outcomes, so excellent outcomes were achieved in 88.9% of cases. These cases were reexamined immediately after their operations, and the X-ray film displayed that fractured parts were well realigned. They were examined again 3 months after their operations. It was found that their bones were healed and no signs of traumatic inflammation were detected. Seventeen cases were found to be negative in anterior drawer test （-） and Lachman test, while another case was observed to be false positive in the anterior drawer test and negative in the Lachman test（t =25.943, P 〈0.001）. The postoperative Lysholm scores were （93.8±3.7） and presented statistical significant differences from preoperative scores （45.2±6.4）（t =27.892, P 〈0.001）. The postoperative IKDC2000 subjective knee joint scores were （90.2±4.2） on average and differed from the preoperative scores （49.8±5.1） with statistical significance （t = 25.943, P 〈0.001）. Postoperative functional recovery of limbs was satisfactory. Conclusion To treat teenagers＇ avulsion fracture of tibial intercondylar eminence

关 键 词：膝关节 前交叉韧带 胫骨髁间隆起撕脱骨折 关节镜 钢丝 可吸收缝线 

分 类 号：R687.3[医药卫生—骨科学]