关节镜下经髌股关节间隙治疗胫骨髁间嵴骨折

Treatment of tibial intercondylar eminence fracture under arthroscopy through patellofemoral joint space

目的：探讨关节镜下经髌股关节间隙治疗胫骨髁间嵴骨折的临床疗效.方法：自2008年9月至2012年9月,收治45例胫骨髁间嵴骨折患者,年龄15～22岁;男32例,女13例;左膝关节29例,右膝关节16例.患者均为新鲜骨折并且外伤后10d之内就诊,常规摄X线片示胫骨髁间嵴骨折.根据Meyers-McKeever骨折分型：Ⅲ型27例,Ⅱ型18例.所有患者采用关节镜下经髌股关节间隙复位固定治疗.术后根据X线片评估骨折愈合情况,并做Lysholm评分.结果：45例患者均获随访,术后3个月拍片复查,骨折均愈合,无膝关节髁间窝撞击引起的伸直受限、膝关节伸直疼痛、膝关节前方不稳定等并发症.Ⅱ型骨折Lysholm评分为92分（85～96分）,Ⅲ型骨折Lysholm评分93分（83～96分）.结论：关节镜下经髌股关节间隙治疗胫骨髁间嵴骨折复位固定简单,手术易操作,结果可靠.

Objective：To evaluate the clinical outcome of arthroscopy techniques for the treatment of tibial intercondylar eminence fractures through patellofemoral joint space.Methods：From September 2008 to S eptember 2012,45 patients （32 males,13 females;ranging in age from 15 to 22 years old） with intercondylar eminence fractures（29 left knees and 16 right knees） were treated with reduction and fixation through pate llofemoral joint space under arthroscopy.All fractures were fresh fracture and were treated within 10 day s after trauma.The fractures were confirmed by X-ray.According to Meyers and McKeever classification,27 patients had fractures with type Ⅲ and 18 patients had fractures with type Ⅱ.After operation,X-ray films were taken to evaluate fracture heal,and Lysholm criteria was used to evaluate therapeutic effects.Results：All the patients were followed up,and all fractures healed at 3 months after operation.During the follow-up period,all the patients had excellent or good results,without complications such as nonunion,limit extension caused by intercondyloid fossa knocking of knee joint,strengthening pain and anterior instability of knee joint.The mean Lysholm score was 92 （ranged,85 to 96） of patients with type Ⅱ fractures,and 93 （ranged,83 to 96） of patients with type Ⅲ fractures.Conclusion：Treatment of tibial intercondylar eminence fractures under arthroscopy through patellofemoral joint space has follow advantages：simple reduction and fixation,easy operation and good clinical outcome.