克氏针逆行固定联合缝线套扎治疗小儿粉碎型胫骨髁间棘骨折  

Treatment of Comminuted Tibial Spine Fractures in Children:Retrograde Kirschner Wire Fixation Combined With Suture Fixation

作　　者：刘尧[1] 朱伦庆[1] 甄允方[1] 王晓东[1] 刘亚 方建峰[1] Liu Yao;Zhu Lunqing;Zhen Yunfang(Department of Orthopedics,Children’s Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属儿童医院骨科,苏州215000

出　　处：《中国微创外科杂志》2022年第11期918-922,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：江苏省卫生健康委医学科研项目(重点项目K2019005)。

摘　　要：目的探讨克氏针逆行固定联合缝线套扎治疗小儿粉碎性胫骨髁间棘骨折的效果。方法2015年1月~2020年12月我科关节镜下治疗11例粉碎性胫骨髁间棘骨折,在前交叉韧带导向器辅助下,对大且厚的骨块采用经皮克氏针逆行固定,对小且薄的软骨片骨折采取缝线套扎固定。结果11例术后均获得良好复位,均获得骨折愈合,无血管神经损伤、骨折移位、骨骺早闭等并发症。11例随访平均14.3月(12~18个月),10例末次随访时Lachman试验、抽屉试验、轴移试验均阴性;1例Lachman试验阳性,但无本体感觉不适。末次随访Lysholm膝关节功能评分(91.4±2.1)分。结论克氏针逆行固定联合缝线套扎治疗小儿粉碎性胫骨髁间棘骨折效果满意。Objective To investigate clinical effects of retrograde Kirschner wire fixation combined with suture fixation for comminuted tibial spine fractures(TSFs)in children.Methods From January 2015 to December 2020,11 children with comminuted TSFs were treated under arthroscopy in our department.With the assistance of anterior cruciate ligament guide,the large and thick fragment were fixed by retrograde K-wires,and the small and thin cartilage fractures were fixed by sutures.Results Anatomic reduction of fractures was achieved in all the patients.All the patients achieved fracture healing without neurovascular injury,fracture displacement,early closure of epiphysis or other complications.The mean follow-up time was 14.3 months(range,12-18 months).The Lachman test,drawer test and axial shift test were negative in 10 patients at the last follow-up,1 patient showed positive Lachman test result without subjectively laxity of the knee.The Lysholm score at the last follow-up was(91.4±2.1)points.Conclusion Retrograde Kirschner wire fixation combined with suture fixation can effectively fix the comminuted TSFs in children.

关 键 词：小儿 粉碎性胫骨髁间棘骨折 骨折固定术 关节镜 

分 类 号：R726.8[医药卫生—儿科]