关节镜下可吸收缝线内固定治疗儿童胫骨髁间棘骨折

Arthroscopic treatment for avulsed fracture of tibial intercondylar eminence with polydioxanone suture fixation in children

目的：探讨关节镜下应用可吸收缝线治疗儿童胫骨髁间棘骨折的手术方法及疗效。方法对2009年1月至2013年6月收治的12例胫骨髁间棘骨折患儿进行关节镜下复位骨折块,以可吸收缝合线 PDS-Ⅱ线（降解时间约6个月）固定骨折块。对患儿资料进行回顾性分析,骨折类型按Meyers 和 McKeever 分型分为：Ⅱ型5例,Ⅲ型7例。研究术后并发症,膝关节活动度的改善,Lach-man 试验及轴移试验结果及末次随访时 Lysholm 评分。结果所有病例均获6~12个月随访,平均10.7个月。所有骨折病例均于3个月内一期愈合。无骨折移位、感染、伤口不愈合、长期持续疼痛等并发症。膝关节活动度：所有患儿平均术后3个月膝关节活动度恢复正常,无伸膝或屈膝受限。所有患儿 Lachman 试验及轴移试验阴性。末次随访时 Lysholm 评分平均97.3±2.7。结论关节镜下应用丝线内固定对于儿童胫骨髁间棘骨折是一种安全有效的治疗方式,不影响胫骨近端骺板发育。

Objective To explore the efficacies of arthroscopic treatment for avulsed fracture of tibial intercondylar eminence with polydioxanone （PDS-II）suture fixation in children.Methods The experiences were summarized for 12 children undergoing arthroscopic treatment for avulsed fracture of tibial intercondylar eminence with PDS-Ⅱ suture fixation from January 2009 to June 2013.According to the Meyers and McKeever classification,the fractures were of type Ⅱ （n=5）and type Ⅲ （n=7）. And the complication,range of motion,Lachman test,pivot test and Lysholm score were evaluated. Results The follow-up period was 6 to 12 months.All of them recovered postoperatively well with a full range of motions without displacement,infection or non-union at 3 months.Lachmann and pivot tests were all negative.The average Lysholm score was 97.3 ± 2.7.Conclusions Arthroscopic treatment with PDS-II suture fixation is both safe and efficacious in the treatment of avulsed fracture of tibial intercondylar eminence in children.