关节镜引导下治疗涉及关节面的股骨髁部骨折

Arthroscope-guided treatment of femoral condylar fracture

目的探讨关节镜引导下微创治疗股骨髁部骨折的临床效果及手术适应证。方法对11例股骨髁部骨折患者采用关节镜引导下复位空心螺钉固定,与之前相同类型骨折采用切开复位内固定的14例患者组进行比较,评估围手术期出血量、手术时间、围手术期并发症及术后膝关节功能。结果全部25例患者均获得随访10～27个月,平均17个月,两组均未发生伤口感染、骨不愈合并发症;关节镜组手术时间相对较长,出血量较少,术后功能恢复明显优于切开组。结论关节镜引导下复位空心螺钉固定股骨髁部骨折具有微创、功能恢复良好等优点,并可对膝内合并损伤进行诊治,对比切开复位具有一定优势。

Objective To investigate the clinical effects and surgical indications of arthroscope- guided treatment of femoral condylar fracture. Methods 11 patients （ seven males, four females ） with condylar fracture treated by arthroscopy with hollow screw in our hospital in recent two years and 14 patients with the same type of fractures treated by open reduction and internal fixation were enrolled in this study. The arthroscopy group and open-reduction group were compared in the amount of perioperative bleeding, operative time, perioperative complications and postoperative knee function. Results All patients were followed up for 10 to 27 months, 17 months in average. There was no wound infection or nonunion complications in the two groups; arthroscopic o arthroscopy group had a relatively longer operation time than open-reduction group, but with less blood loss, and remarkably superior postoperative functional recovery. Conclusions Arthroscope-guided treatment of femoral condylar fracture with hollow screw is minimal invasive, and can achieve good functional recovery. It has obvious advantages in the diagnosis and treatment of knee injuries.