关节镜技术结合锚钉固定治疗Segond骨折的临床疗效  

Clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures

作　　者：潘家平 王徐灿 黄鸣红 朱裕昌[2] 

机构地区：[1]宁波市第四医院骨科,浙江省宁波市315700 [2]同济大学附属第十人民医院骨科

出　　处：《中华创伤杂志》2018年第3期225-229,共5页Chinese Journal of Trauma

摘　　要：目的探讨关节镜技术结合锚钉固定治疗Segond骨折的临床疗效。方法采用回顾性病例系列研究分析2011年1月-2015年12月行关节镜技术结合锚钉固定治疗的29例Segond骨折患者的临床资料，其中男17例，女12例；年龄27-62岁，平均41岁。合并伤：前交叉韧带（ACL）断裂20例，后交叉韧带（PCL）断裂3例，内侧副韧带（MCL）损伤7例，外侧副韧带（LCL）断裂6例，半月板损伤12例，胫骨平台骨折2例。受伤至手术时间5-14d，平均7d。记录手术时间、术中出血量。观察术后疼痛、并发症、膝关节稳定性、骨折愈合等情况。采用疼痛数字评分评估疼痛情况。采用抽屉试验、Lachman试验、侧方应力试验及Lysholm评分评价膝关节功能。结果手术时间40～125min，平均85min。术中出血量10-30ml，平均15rnl。术后患者均获随访12～18个月，平均14个月。术后2周后疼痛不明显（疼痛数字评分0-1分）。1例术后l周出现患肢深静脉血栓，经内科介入治疗后治愈，其他患者均无感染、深静脉血栓等术后并发症。抽屉试验、Lachman试验及侧方应力试验均为阴性，膝关节稳定性好。患者均获骨性愈合，愈合率为100％。Lysholm评分术前为35-62分[（52．0±4．2）分]，术后1年为86～95分[（91．9±1．4）分]（P〈0．05）。结论利用关节镜技术结合锚钉固定治疗Segond骨折，具有创伤小、出血少、骨折愈合率高及膝关节术后功能恢复效果好等优点，是一种有效的外科治疗方法。Objective To evaluate the clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures. Methods A total of 29 patients with Segond fractures treated with arthroscopic evaluation and anchor fixation technique between January 2011 and December 2015 were included in this retrospective case series study. There were 17 males and 12 females, with an average age of 41 years （range, 27-62 years）. Among the patients with Segond fractures, there were 20 patients combined with anterior cruciate ligament （ACL） rupture, three with posterior cruciate ligament （PCL） rupture, seven with medial collateral ligament （MCL） lesion, six with lateral collateral ligament （LCL） rupture, 12 with meniscus lesion, and two with tihial plateau fracture. The time duration from injury to operation was 5-14 days （mean, 7 days）. The operation time and intraoperative blood loss volume were recorded. The postoperative pain, complications, knee joint stability, and fracture healing were observed. The pain was evaluated using numerical rating scale （NRS）. Drawer test, Lachman test, lateral stress test, and Lysholm scores were performed to assess the knee function before and after operation. Results The operation time was 40-125 minutes （ mean, 85 minutes）, and intraoperative blood loss was 10-30 ml （mean, 15 ml）. All patients were followed up for 12-18 months （mean, 14 months）. Two weeks after operation, the pain was not obvious, with NRS of 0-1. One patient had deep venous thrombosis one week after operation, and recovered after vascular intervention therapy. Other patients had no infection, deepvein thrombosis or other postoperative complications. The results of drawer test, Lachman test, and lateral stress test were negative in all patients, which indicated good knee joint stability. All patients were seen bone union, with the healing rate of 100%. The preoperative Lysholm scores were 35-62 points [ （52.0 ± 4.2） points ] , and the scores one year after operation were 86-95 point

关 键 词：胫骨骨折 前交叉韧带 后交叉韧带 半月板 

分 类 号：R687[医药卫生—骨科学]