摘要
目的讨论关节镜辅助下治疗胫骨髁间前棘撕脱骨折的手术方法及临床疗效。方法2004年5月至2007年12月我科对收治的30例胫骨髁间前棘撕脱骨折患者行关节镜下胫骨髁间前棘撕脱骨折复位、空心拉力螺钉内固定术,其中男性20例,女性10例,年龄15～79岁,平均年龄32.0岁;急性损伤12例,陈旧性损伤18例;按Meyers-McKeever-Zaricnyl’s分型:Ⅱ型8例,Ⅲ型15例,Ⅳ型7例。术后行患肢股四头肌功能锻炼及主动伸屈关节锻炼。出院后通过随访信及门诊复查方式给予随访,采用Lysholm及Irrgang评分标准评价疗效。结果30例患者术后均获随访,时间3～60个月,平均31.2个月。术后2个月复查X线片均见骨性愈合,患者无主观膝关节不稳感,与健侧对比Lachman试验、前抽屉试验、轴移试验均为阴性,关节屈伸活动恢复正常,Lysholm评分由术前(60.8±1.5)分增至(95.5±3.5)分,Irrgang评分由术前(55.5±3.3)分增至(90.5±2.5)分。结论关节镜辅助下用空心拉力螺钉治疗髁间前棘撕脱骨折,是一种创伤小、固定可靠、操作方便快捷、疗效确实的方法。
Objective To investigate the outcomes of arthroscopic reduction and internal fixation with cannulate lag screw for avulsion fracture of tibial intercondylar anterior eminence. Methods From May 2004 to December 2007, 30 cases of tibial intercondylar anterior eminence avulsion fracture were treated by arthroseopic reduction and fixation with cannulated lag screw. Among the patients, there were 10 females and 20 males, ranging from 15 to 79 years old with an average age of 32. O. There were 12 fresh fractures and 18 old fractures. According to Meyers-McKeever-Zarienyl＇ s classification systems, there were 8 cases of type Ⅱ , 15 cases of type Ⅲ, and 7 cases of type Ⅳ. Patients were encouraged to do postoperative rehabilitation, such as active joint extension and flexion, exercise of isometric contraction of quadrieeps femoris. The treatment outcomes were evaluated by Lysholm and Irrgang knee score system. Results All patients were followed up for 3 months to 60 months （averaging 31.2 months）. X rays revealed bony healing 2 months after operation . The joints were stable. Negative Lachaman and drawer and jerk tests were found in all cases, and there was no dysfunction in the knee joints. Lysholm scores were increased from （60.8 ± 1.5 ） to （95.5 ± 3.5） while Irrgang scores increased from （55.5 ±3.3） to （90.5 ±2.5）. Conclusion Arthroscopic treatment of avulsion fracture of tibial intereondylar anterior eminence is an easy approach with minimal invasion, and has reliable reduction and fixation with satisfied results.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2009年第7期626-628,共3页
Journal of Third Military Medical University
关键词
关节镜
空心拉力螺钉
胫骨髁间前棘
撕脱骨折
arthroseopy
cannulate lag screw
intereondylar anterior eminence
avulsion fracture
