关节镜下细小钢丝置入内固定修复新鲜和陈旧型胫骨髁间棘骨折

Fresh and old tibial intercondylar eminence fracture by arthroscopic wire fixation

背景:关节镜下治疗胫骨髁间棘骨折,置入的钢丝直径较为细小,手术过程中对骺板的损伤较小,固定牢靠性较强,固定后患者可早期进行活动锻炼,明显减轻对患者的机体损伤,加快伤口愈合速度,减少并发症的发生。目的:探讨关节镜下细小钢丝置入内固定修复新鲜和陈旧型胫骨髁间棘骨折的生物相容性。方法:选取2010年1月至2012年4月在宜昌市第二人民医院行关节镜下微创钢丝固定治疗的25例新鲜和陈旧性胫骨髁间棘骨折患者,观察两组患者固定后骨折愈合时间以及膝关节功能改善情况。结果与结论:与新鲜骨折组相比,陈旧骨折组骨折愈合时间、拉赫曼试验阳性率升高(P<0.05),膝关节屈伸活动度和吕斯霍尔姆评分减低(P<0.05),结果证实,关节镜下细小钢丝置入内固定修复新鲜和陈旧型胫骨髁间棘骨折均有临床应用的可行性。

BACKGROUND： Arthroscopic treatment of tibial eminence fracture requires tiny wire, induces less epiphyseal plate damage during operations, obtains strong fixat!ons, allows early movement postoperatively, obviously attenuate the injuries, facilitate wound healing, and reduce complications. OBJECTIVE： To investigate the biocompatibility of arthroscopic reduction and wire fixation in treatment of fresh and old tibial eminence fractures. METHODS： Twenty-five patients with fresh and old tibial eminence fractures were treated with arthrescopic reduction and wire fixation from January 2010 to April 2012 in the Second People＇s Hospital of ~ichang City, The postoperative fracture healing time and knee function improvement in the two groups were observed. RESULTS AND CONCLUSION： Compared with the fresh fracture patients, the fracture healing time was longer, Lachman test positive rate was higher in the old fracture patients than （P 〈 0.05）, knee flexion and extension activity and Lysholm score were lower （P 〈 0.05）. Experimental findings indicate that, arthroscopic reduction and wire fixation is a feasible clinical treatment of fresh and old tibial intercondylar eminence fractures.