关节镜治疗青少年胫骨髁间隆突撕脱骨折

Arthroscopic Fixation of Tibial Intercondylar Eminence Avulsion Fracture in Adolescent

目的探讨关节镜监视下复位内固定治疗青少年胫骨髁间隆突撕脱骨折的方法与疗效。方法 2008年1月至2012年6月,本科收治青少年胫骨髁间隆突撕脱骨折31例,男19例,女12例;年龄7-16岁,平均13.1岁。根据Meyers-Mckeever-Zaricnyi分型,Ⅱ型13例,Ⅲ型18例（ⅢA型11例,ⅢB型7例）,采用关节镜监视下骨折复位,薇乔可吸收线固定14例,钢丝固定17例。结果术后随访26例,随访时间12-36个月,平均25.7个月。术后膝关节Lyscholm评分,薇乔线组（90.4±3.6）分,钢丝组（90.7±2.9）分。薇乔线组与钢丝组术后功能差异无统计学意义。X线片显示骨折块复位好,骨性愈合,膝关节功能恢复好。结论关节镜监视下复位内固定治疗青少年胫骨髁间隆突骨折,创伤小,内固定可靠,并发症少,关节功能恢复快。

Objective To investigate the cliHnical effects of arthoscopic fixation for displaced tibial intercondylar eminence avulsion fracture with steel wires and VICRYL Rapide.Methods From January 2005 to June 2012,31 patients（male 19,female 12;type Ⅱ 13 cases,type Ⅲ 18 cases） with an average age of 13.1 years（range 7 - 16） who suffered displaced tibial intercondylar eminence avulsion fracture underwent surgery treatment,including 14 cases fixed with VICRYL Rapide,17 cases fixed with steel wires.Results Twenty-six patients were followed-up（range from 12 to 36 months with an average 25.7months）.Radiological examination showed anatomical reduction in fracure sites at the final of follow-up.The Lysholm scores of VICRYL Rapide group is 90.4 ± 3.6 points,steel wires group is 90.7 ± 2.9 points.There is no statistic difference.Conclusion Arthroscopic fixation for displaced tibial intercondylar eminence avulsion fracture with steel wire and VICRYL Rapide can be applied to all types of avulsion fracture,and it has the advantage of simple technique,minimal invasion,stable fixation,fewer complications,earlier rehabilitation of knee joint,and convenience for fixator removal extra-articularlly.